NPIMap

Organization Active NPI

Womans Healthcare Associates PC

Doing business as Premier Healthcare for Women

  • Obstetrics & Gynecology Physician
  • Lafayette, IN
National Provider Identifier
1528344207
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMANS HEALTHCARE ASSOCIATES PC
Doing business as
Premier Healthcare for Women
Practice address
3774 Bayley Dr
Suite B
Lafayette, IN 47905-8651
Phone
(765) 807-2280
Fax
(765) 807-2281
NPI assigned
Oct 26, 2011
Last updated
Aug 25, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
WOMANS HEALTHCARE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Authorized official

Name
Robert Ideson
Title
Administrator
Phone
(765) 428-5888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

3774 Bayley Dr
Suite B
Lafayette, IN 47905-8651

Mailing address

PO Box 7010
Lafayette, IN 47903-7010
Phone (765) 428-5888

Other identifiers 1

IdentifierTypeStateIssuer
100230540BMedicaidIN

Other names 1

  • PREMIER HEALTHCARE FOR WOMEN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040723000741 IN Part B Supplier - Clinic/Group Practice 4789664202 Receives reassigned benefits from 21 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lafayette, IN

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Woman's Healthcare Associates PC

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1528344207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7010",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479037010",
            "telephone_number": "765-428-5888",
            "fax_number": "765-428-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3774 BAYLEY DR",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479058651",
            "telephone_number": "765-807-2280",
            "fax_number": "765-807-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMANS HEALTHCARE ASSOCIATES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOMANS HEALTHCARE ASSOCIATES",
        "enumeration_date": "2011-10-26",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "IDESON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "765-428-5888"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230540B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PREMIER HEALTHCARE FOR WOMEN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.