NPIMap

Organization Active NPI

Alpine Clinic, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lafayette, IN
National Provider Identifier
1548274202
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ALPINE CLINIC, LLC
Practice address
3660 Rome Dr
Lafayette, IN 47905-4488
Phone
(765) 446-9394
Fax
(765) 447-8875
NPI assigned
Jul 28, 2006
Last updated
Jul 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Nizar El-Khalili, M.D.NPI 1861429714
Title
Owner/Medical Director
Phone
(765) 446-9394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Psychiatry Physician 2084P0800X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

3660 Rome Dr
Lafayette, IN 47905-4488

Mailing address

3660 Rome Dr
Lafayette, IN 47905-4488
Phone (765) 446-9394

Other identifiers 1

IdentifierTypeStateIssuer
200239900AMedicaidIN

National Provider Directory

National Provider Directory

Locations

100 Executive Dr
Ste J
Lafayette, IN 47905
Phone (765) 446-9391

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1548274202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 ROME DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054488",
            "telephone_number": "765-446-9394",
            "fax_number": "765-447-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 ROME DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054488",
            "telephone_number": "765-446-9394",
            "fax_number": "765-447-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "EL-KHALILI",
        "authorized_official_first_name": "NIZAR",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "765-446-9394",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200239900A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 20, 2010; 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.