Creekside OBGYN PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

50004241A Issued in IN

Legal business name

CREEKSIDE OBGYN PC

Practice address

2505 N Lebanon St
Ste 208
Lebanon, IN 46052-8612

Phone

(765) 485-8444

Fax

(765) 483-7365

NPI assigned

Sep 13, 2005

Organization subpart

Yes

Parent organization

WITHAM MEMORIAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Sandra L Anderson

Title

Office Manager

Phone

(765) 483-7361

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Hoosier Enterprises II Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Witham Memorial Hospital

  • Skilled Nursing Facility
  • Clinton, IN
  • NPI 1942372511

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1639164999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 N LEBANON ST",
            "address_2": "STE 208",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528612",
            "telephone_number": "765-485-8444",
            "fax_number": "765-483-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 N LEBANON ST",
            "address_2": "STE 208",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528612",
            "telephone_number": "765-485-8444",
            "fax_number": "765-483-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE OBGYN PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WITHAM MEMORIAL HOSPITAL",
        "enumeration_date": "2005-09-13",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "765-483-7361"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "50004241A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200293550",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cowan Drugs Inc
• Cowan Drugs Inc
• John A Cowan, RPH
• Carleigh Craig, RBT
• Sheri Lynne Crandall
• Brittany Crider, MA, BCBA
• Hannah Ziker Croffie, NP-C
• Abigail Crum, LAT, ATC
• Cheyenne Crum, RBT
• Stacie Nicole Curtis, NP

• Obstetrics & Gynecology Physician in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.