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Organization Active NPI

Emergency Medicine Professionals of Indiana LLC

  • Emergency Medicine Physician
  • Bloomington, IN
National Provider Identifier
1639109945
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY MEDICINE PROFESSIONALS OF INDIANA LLC
Practice address
4011 So Monroe Medical Park Blvd
Bloomington, IN 47403-9765
Phone
(812) 824-5700
Fax
(812) 825-0766
NPI assigned
Jul 3, 2006
Last updated
Jun 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Authorized official

Name
Mark E Manship, MD
Title
President
Phone
(317) 870-0480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

4011 So Monroe Medical Park Blvd
Bloomington, IN 47403-9765

Mailing address

PO Box 1204
Indianapolis, IN 46206-1204
Phone (317) 802-3160

Other identifiers 1

IdentifierTypeStateIssuer
200828620AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1639109945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061204",
            "telephone_number": "317-802-3160",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 SO MONROE MEDICAL PARK BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474039765",
            "telephone_number": "812-824-5700",
            "fax_number": "812-825-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICINE PROFESSIONALS OF INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "MANSHIP",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-870-0480",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200828620A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.