Southern Indiana Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SOUTHERN INDIANA PEDIATRICS, LLC

Practice address

350 S Landmark Ave
Bloomington, IN 47403-5001

Phone

(812) 335-2434

Fax

(812) 335-7604

NPI assigned

Feb 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Craig

Title

Cfo

Phone

(812) 353-9554

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Indiana University Health Southern Indiana Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Martinsville, IN
  • NPI 1740608926

  Member Of

  NPD member

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518652800000",
    "number": "1417921933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-335-2434",
            "fax_number": "812-335-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-335-2434",
            "fax_number": "812-335-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INDIANA PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2018-02-15",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-353-9554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200026580",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Indiana Family Practice Center PC
• Southern Indiana Hearing Solutions
• Southern Indiana Home Care
• Southern Indiana Pathologists
• Southern Indiana Pediatric Dentistry, LLC
• Southern Indiana Physicians for Women
• Southern Indiana Radiological Associates Inc
• Southern Indiana Senior Care, Inc
• Southern Indiana Surgery Center, LLC
• Melanie Southern

• Pediatrics Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; 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.