NPIMap

Organization Active NPI

Indiana University Health Paoli Inc

Doing business as IU Health Paoli

  • Emergency Medical Services (Emergency Medicine) Physician
  • Paoli, IN
National Provider Identifier
1457519324
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
INDIANA UNIVERSITY HEALTH PAOLI INC
Doing business as
IU Health Paoli
Practice address
642 W Hospital Rd
Paoli, IN 47454-9672
Phone
(812) 723-2811
Fax
(812) 723-7506
NPI assigned
May 28, 2008
Last updated
Oct 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Mrs. Donna Jean Morgan
Title
Controller
Phone
(812) 723-7430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU Primary

Addresses

Primary practice location

642 W Hospital Rd
Paoli, IN 47454-9672

Mailing address

642 W Hospital Rd
Paoli, IN 47454-9672
Phone (812) 723-2811

Other identifiers 1

IdentifierTypeStateIssuer
163460MedicaidIN

Other names 1

  • IU Health Paoli Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050308001174 IN Part B Supplier - Clinic/Group Practice 2668426016 Receives reassigned benefits from 55 practitioners
Practice locations: Paoli, IN

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member of 2

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

Member organizations 10

Organizations listed as members of this organization in the National Provider Directory.

Locations

7992 Solution Ctr
Chicago, IL 60677

560 W Longest St
Paoli, IN 47454
Phone (812) 723-7437

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1457519324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 W HOSPITAL RD",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474549672",
            "telephone_number": "812-723-2811",
            "fax_number": "812-723-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 W HOSPITAL RD",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474549672",
            "telephone_number": "812-723-2811",
            "fax_number": "812-723-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH PAOLI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "812-723-7430",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Health Paoli",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paoli, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.