Organization Active NPI

Family and Alternative Wellness

  • Independent Medical Examiner Physician
  • Crawfordsville, IN
National Provider Identifier
1457558686
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner PhysicianTaxonomy code 202C00000X
License
02001756A Issued in IN
Legal business name
FAMILY AND ALTERNATIVE WELLNESS
Practice address
601 Mill St
Crawfordsville, IN 47933-3440
Phone
(765) 362-7600
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Authorized official

Name
Mrs. Delorse Lynne Krug, OFFICE MANAGER
Title
Owner
Phone
(765) 362-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202C00000X 02001756A IN Primary

Addresses

Primary practice location

601 Mill St
Crawfordsville, IN 47933-3440

Mailing address

1627 W Country Club Rd
Crawfordsville, IN 47933-2206
Phone (765) 362-4551

Other identifiers 1

IdentifierTypeStateIssuer
200172010MedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Family and Alternative Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1457558686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 W COUNTRY CLUB RD",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479332206",
            "telephone_number": "765-362-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MILL ST",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479333440",
            "telephone_number": "765-362-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND ALTERNATIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "KRUG",
        "authorized_official_first_name": "DELORSE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-362-7600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OFFICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Independent Medical Examiner",
            "state": "IN",
            "license": "02001756A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200172010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.