Active NPI
Northeast Indiana Anesthesiology, PC
- Anesthesiology Physician
- Columbia City, IN
National Provider Identifier
1619917366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- NORTHEAST INDIANA ANESTHESIOLOGY, PC
- Practice address
- 353 N Oak St
Columbia City, IN 46725-1623 - Phone
- (260) 248-9304
- NPI assigned
- Jun 8, 2006
- Last updated
- Jun 18, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Karyn Kovach
- Title
- Director of Billing
- Phone
- (419) 531-8808
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
353 N Oak St
Columbia City, IN 46725-1623
Mailing address
2914 S Republic Blvd
Toledo, OH 43615-1912
Phone (419) 531-8808
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200366600B | Medicaid | IN | |
| 200366600A | Medicaid | IN | |
| 200366600C | Medicaid | IN | |
| CJ6762 | Other | IN | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
2914 S Republic Blvd
Toledo, OH 43615
Practitioners & affiliated clinicians
Practitioners 31
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.
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Anesthesiology
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213747200000",
"number": "1619917366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2914 S REPUBLIC BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436151912",
"telephone_number": "419-531-8808",
"fax_number": "419-531-8877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "353 N OAK ST",
"city": "COLUMBIA CITY",
"state": "IN",
"postal_code": "467251623",
"telephone_number": "260-248-9304"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHEAST INDIANA ANESTHESIOLOGY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-08",
"last_updated": "2008-06-18",
"status": "A",
"authorized_official_last_name": "KOVACH",
"authorized_official_first_name": "KARYN",
"authorized_official_title_or_position": "DIRECTOR OF BILLING",
"authorized_official_telephone_number": "419-531-8808",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200366600B",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200366600A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200366600C",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CJ6762",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.