NPIMap

Organization Active NPI

ENT Associates of Southern Indiana, P.C.

  • Otolaryngology Physician
  • Bedford, IN
National Provider Identifier
1619048402
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
50000616A Issued in IN
Legal business name
ENT ASSOCIATES OF SOUTHERN INDIANA, P.C.
Practice address
2129 16TH St
Bedford, IN 47421-3003
Phone
(812) 277-0788
Fax
(812) 339-2934
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Denise Lynn West
Title
Office Manager
Phone
(812) 332-2226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 50000616A IN Primary

Addresses

Primary practice location

2129 16TH St
Bedford, IN 47421-3003

Mailing address

2920 McIntyre Dr
Ste 350
Bloomington, IN 47403-4221
Phone (812) 332-2226

National Provider Directory

National Provider Directory
Tax ID family
ENT Associates of Southern Indiana PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619048402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 MCINTYRE DR",
            "address_2": "STE 350",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034221",
            "telephone_number": "812-332-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 16TH ST",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213003",
            "telephone_number": "812-277-0788",
            "fax_number": "812-339-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT ASSOCIATES OF SOUTHERN INDIANA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "812-332-2226"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "50000616A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.