Organization Active NPI

Union Associated Physicians Clinic, LLC

  • Obstetrics & Gynecology Physician
  • Brazil, IN
National Provider Identifier
1619200094
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Practice address
1214 E National Ave
Brazil, IN 47834-2700
Phone
(812) 232-0564
Fax
(812) 242-3861
NPI assigned
Sep 16, 2009
Organization subpart
Yes
Parent organization
UNION ASSOCIATED PHYSICIANS CLINIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Authorized official

Name
Michael P Fouty
Title
Cfo
Phone
(812) 232-0564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1214 E National Ave
Brazil, IN 47834-2700

Mailing address

221 S 6TH St
Terre Haute, IN 47807-4214
Phone (812) 232-0564

Other identifiers 2

IdentifierTypeStateIssuer
200975660MedicaidIN
DQ0893OtherINRAILROAD MEDICARE

National Provider Directory

National Provider Directory
Part of
Union Associated Physicians

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1619200094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S 6TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478074214",
            "telephone_number": "812-232-0564",
            "fax_number": "812-242-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 E NATIONAL AVE",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478342700",
            "telephone_number": "812-232-0564",
            "fax_number": "812-242-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION ASSOCIATED PHYSICIANS CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNION ASSOCIATED PHYSICIANS CLINIC, LLC",
        "enumeration_date": "2009-09-16",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "FOUTY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-232-0564"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200975660",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ0893",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brazil, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.