NPIMap

Organization Active NPI

St Joseph Primary Care Physicians, LLC

Doing business as Associated Internal Medicine

  • Internal Medicine Physician
  • Peru, IN
National Provider Identifier
1417904152
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01045818A Issued in IN
Legal business name
ST JOSEPH PRIMARY CARE PHYSICIANS, LLC
Doing business as
Associated Internal Medicine
Practice address
1692 W Logansport Rd
Peru, IN 46970-3149
Phone
(765) 472-4460
Fax
(765) 472-4548
NPI assigned
May 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gregory A Quin, MD
Title
Physician
Phone
(765) 472-4460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01045818A IN Primary

Addresses

Primary practice location

1692 W Logansport Rd
Peru, IN 46970-3149

Mailing address

1692 W Logansport Rd
Peru, IN 46970-3149
Phone (765) 472-4460

Other names 1

  • Associated Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Primary LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1692 W Logansport Rd
Peru, IN 46970
Phone (260) 726-9027

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417904152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 W LOGANSPORT RD",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469703149",
            "telephone_number": "765-472-4460",
            "fax_number": "765-472-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 W LOGANSPORT RD",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469703149",
            "telephone_number": "765-472-4460",
            "fax_number": "765-472-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH PRIMARY CARE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "765-472-4460",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01045818A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associated Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peru, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.