NPIMap

Individual provider Active NPI

Jerry R Powell II, MD

  • Family Medicine Physician
  • Rochester, IN
National Provider Identifier
1619958378
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01053633 Issued in IN
Practice address
1400 E 9TH St
Rochester, IN 46975
Phone
(574) 224-1048
Fax
(574) 224-1103
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01053633A IN
Family Medicine Physician 207Q00000X 01053633 IN Primary

Addresses

Primary practice location

1400 E 9TH St
Rochester, IN 46975

Mailing address

1400 E 9TH St
Rochester, IN 46975-8937
Phone (574) 224-1048

Other practice location 1

239 Ash St
Tipton, IN 46072-1752
Phone (765) 675-8733

Other practice location 2

239 Ash St
Tipton, IN 46072-1752
Phone (765) 675-8733

Other identifiers 2

IdentifierTypeStateIssuer
200001940AMedicaidIN
200231510MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040225000749 IN Practitioner - Family PracticePractitioner - Emergency Medicine 5698661775 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Company of Tennessee PLLCGroup PAC ID 0345588109, 68 clinicians
Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

1400 E 9TH St
Rochester, IN 46975-8931
Phone (888) 264-0330

441 N Wabash Ave
Marion, IN 46952-2612
Phone (765) 660-6000

Hospital & facility affiliations

  • Marion General Hospital Hospital, Marion, IN, CCN 150011
  • Woodlawn Hospital Hospital, Rochester, IN, CCN 151313

Merit-based Incentive Payment System (MIPS)

Final score
95.38 of 100Reported as group
Quality
87.23
Promoting interoperability
100
Improvement activities
40
Cost
83.74

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01053633INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medicine Man Medical, PLLC Current Accepting new patients
Concord Medical Group of Kentucky PLLC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Vitality Ageless Center LLC Family Medicine CurrentSince Dec 10, 2024 Accepting new patients
Concord Company of Tennessee PLLC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Woodlawn Hospital Family Medicine Current Accepting new patients
Marion General Hospital CurrentSince Jan 26, 2023 Accepting new patients
Regenerative Health Institute P.C. CurrentSince Apr 13, 2021 Accepting new patients
Marion General Hospital Family Medicine CurrentSince Jan 26, 2023 Accepting new patients
Indiana Pain and Injury Centers LLC PastSince Oct 20, 2019 Accepting new patients
Emergency Medicine of Indiana Emergency Medicine Past Accepting new patients
Innovative Hospital Care Inc Past Accepting new patients
Mid State Logansport Ed Physicians Emergency Medicine Past Accepting new patients
Wabash Em I Medical Services PC Past Accepting new patients
Emergency Physicians of Indiana PC Emergency Medicine Past Accepting new patients

Locations

1300 Peachtree Industrial Blvd
Ste 1201
Suwanee, GA 30024
Phone (770) 614-6266

20 Executive Dr
Ste A
Carmel, IN 46032
Phone (317) 993-3361

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

1400 E 9th St
Rochester, IN 46975
Phone (574) 223-2020

2200 N Section St
Sullivan, IN 47882
Phone (812) 268-6292

8885 State Road 237
Tell City, IN 47586
Phone (812) 547-0185

Interoperability endpoints

  • Direct secure messaging: jpowell8889@direct.parkviewexchange.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1619958378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 9TH ST",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469758937",
            "telephone_number": "574-224-1048",
            "fax_number": "574-224-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 9TH ST",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "46975",
            "telephone_number": "574-224-1048",
            "fax_number": "574-224-1103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 Ash St",
            "address_purpose": "LOCATION",
            "city": "Tipton",
            "state": "IN",
            "postal_code": "460721752",
            "country_code": "US",
            "telephone_number": "765-675-8733",
            "fax_number": "765-675-7121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 Ash St",
            "address_purpose": "LOCATION",
            "city": "Tipton",
            "state": "IN",
            "postal_code": "460721752",
            "country_code": "US",
            "telephone_number": "765-675-8733",
            "fax_number": "765-675-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JERRY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01053633A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01053633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200001940A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200231510",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, IN

Sources for this page

Verify at the official NPI Registry.