Organization Active NPI

American Health Network of Indiana, LLC

  • Podiatrist
  • Indianapolis, IN
National Provider Identifier
1508083999
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Practice address
8333 Naab Rd
Entrance 7
Indianapolis, IN 46260-5924
Phone
(317) 338-9000
NPI assigned
Apr 19, 2007
Organization subpart
Yes
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Ben H Park, MD
Title
President and Ceo
Phone
(317) 580-6314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

8333 Naab Rd
Entrance 7
Indianapolis, IN 46260-5924

Mailing address

18051 River Ave
Suite 200
Noblesville, IN 46062-7091
Phone (317) 843-2613

Other identifiers 1

IdentifierTypeStateIssuer
200303560AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000691 IN Part B Supplier - Clinic/Group Practice 9830093533 Receives reassigned benefits from 230 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
American Health Network LLC

Locations

8333 Naab Rd
#7
Indianapolis, IN 46260
Phone (317) 338-9000

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1508083999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18051 RIVER AVE",
            "address_2": "SUITE 200",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460627091",
            "telephone_number": "317-843-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD",
            "address_2": "ENTRANCE 7",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605924",
            "telephone_number": "317-338-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "317-580-6314",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200303560A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.