Individual provider Active NPI

Hani Walid Jaouni, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Richmond, IN
National Provider Identifier
1619063856
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
01070366A Issued in IN
Practice address
1100 Reid Pkwy
Richmond, IN 47374-1157
Phone
(765) 983-3000
Fax
(765) 935-8944
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2005023731 MO
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01070366A IN Primary

Addresses

Primary practice location

1100 Reid Pkwy
Richmond, IN 47374-1157

Mailing address

1100 Reid Pkwy
Medical Staff Services
Richmond, IN 47374-1157
Phone (765) 983-0000

Other practice location 1

1701 E Broadway
Ste 302
Columbia, MO 65201-8018
Phone (573) 815-7119

Other practice location 2

1701 E Broadway Ste 302
Columbia, MO 65201-8018
Phone (573) 815-7119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2005023731MOMDInternal Medicine Physician
01070366AINMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hale County Hospital Past Accepting new patients
Physician Groups LC Internal Medicine Past Accepting new patients
Hale County Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hjaouni315452@ecommunitydirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1619063856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-0000",
            "fax_number": "765-935-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3000",
            "fax_number": "765-935-8944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 E Broadway",
            "address_2": "Ste 302",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652018018",
            "country_code": "US",
            "telephone_number": "573-815-7119",
            "fax_number": "573-815-7116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 E Broadway Ste 302",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652018018",
            "country_code": "US",
            "telephone_number": "573-815-7119",
            "fax_number": "573-815-7116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAOUNI",
        "first_name": "HANI",
        "middle_name": "WALID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2005023731",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01070366A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.