NPIMap

Organization Active NPI

St Catherine Physician Services of Indiana

  • Family Medicine Physician
  • Henryville, IN
National Provider Identifier
1629252515
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01052944A Issued in IN
Legal business name
ST CATHERINE PHYSICIAN SERVICES OF INDIANA
Practice address
417 West Colonel Way
Henryville, IN 47126
Phone
(812) 294-1470
NPI assigned
Dec 27, 2007
Last updated
Mar 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Robert Lane
Title
Ceo
Phone
(812) 256-3301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01052944A IN Primary

Addresses

Primary practice location

417 West Colonel Way
Henryville, IN 47126

Mailing address

417 West Colonel Way
Henryville, IN 47126
Phone (812) 294-1470

Other identifiers 2

IdentifierTypeStateIssuer
H30374OtherINUPIN
000000550438OtherINANTHEM BC/BS

National Provider Directory

National Provider Directory

Locations

417 Colonels Way W
Henryville, IN 47126
Phone (812) 294-1470

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1629252515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 WEST COLONEL WAY",
            "city": "HENRYVILLE",
            "state": "IN",
            "postal_code": "47126",
            "telephone_number": "812-294-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 WEST COLONEL WAY",
            "city": "HENRYVILLE",
            "state": "IN",
            "postal_code": "47126",
            "telephone_number": "812-294-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CATHERINE PHYSICIAN SERVICES OF INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-256-3301"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01052944A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "H30374",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000550438",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henryville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.

Verify at the official NPI Registry.