Organization Active NPI

United Anesthesiologists of Northern Indiana

  • Anesthesiology Physician
  • Mishawaka, IN
National Provider Identifier
1629021613
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
UNITED ANESTHESIOLOGISTS OF NORTHERN INDIANA
Practice address
4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1442
Phone
(574) 575-0335
NPI assigned
May 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Christopher Nelson, MD
Title
President
Phone
(574) 575-0335

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

4455 Edison Lakes Pkwy
Mishawaka, IN 46545-1442

Mailing address

541 Otis Bowen Dr
Munster, IN 46321-4158
Phone (219) 934-5300

National Provider Directory

National Provider Directory

Locations

4455 Edison Lakes Pkwy
Mishawaka, IN 46545
Phone (574) 231-6134

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629021613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 OTIS BOWEN DR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214158",
            "telephone_number": "219-934-5300",
            "fax_number": "219-934-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451442",
            "telephone_number": "574-575-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED ANESTHESIOLOGISTS OF NORTHERN INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-575-0335",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.