Interlocal Community Action Program

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

Legal business name

INTERLOCAL COMMUNITY ACTION PROGRAM

Practice address

1912 Bundy Ave
New Castle, IN 47362-2918

Phone

(765) 521-1401

NPI assigned

Mar 21, 2007

Last updated

Jul 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Polivick

Title

Executive Director

Phone

(765) 529-4403

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mother Child Center Other name

Locations

Practitioners 1

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.

• Nancy Lewis, RN

  • Licensed Practical Nurse
  • New Castle, IN
  • NPI 1639357460
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1538285838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 BUNDY AVE",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473622918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 BUNDY AVE",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473622918",
            "telephone_number": "765-521-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERLOCAL COMMUNITY ACTION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "POLIVICK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "765-529-4403",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100134600",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mother Child Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dung V Huynh, DDS
• Tamara Lee Imel, LMHC
• Indiana Physician Management-Henry, LLC
• Indiana Signal Health Group Non-Skilled
• Indiana Signal Health Group Non-Skilled
• Bruce Duane Ippel, MD
• Julia Irish
• J E Poe Home Care Inc
• Trina Diann Jenkins
• Camari Jernigan

• Gynecologic Oncology Physician in New Castle, IN
• Providers in New Castle, IN by specialty
• Gynecologic Oncology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.