Indiana Care Organization, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

INDIANA CARE ORGANIZATION, LLC

Practice address

10689 N Pennsylvania St Ste 200
Indianapolis, IN 46280-1099

Phone

(317) 580-6309

Fax

(317) 580-6309

NPI assigned

Aug 24, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Ben Park, MDNPI 1841377702

Title

President and Ceo

Phone

(317) 580-6314

Specialties & licenses 1

Addresses

Other names 1

• American Health Network of Indiana Premier ACO Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ben H Park, MD

  • Family Medicine Physician
  • Lebanon, IN
  • NPI 1841377702
  NPD Authorized official

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1619458940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10689 N PENNSYLVANIA ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462801099",
            "telephone_number": "317-580-6309",
            "fax_number": "317-580-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10689 N PENNSYLVANIA ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462801099",
            "telephone_number": "317-580-6309",
            "fax_number": "317-580-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA CARE ORGANIZATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "317-580-6314",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Health Network of Indiana Premier ACO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Indiana Center for Advanced Medicine
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• Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.