Organization Active NPI

Afaq Medical Services LLC

  • Specialist
  • Jeffersonville, IN
National Provider Identifier
1639340953
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01057489A Issued in IN
Legal business name
AFAQ MEDICAL SERVICES LLC
Practice address
2700 Vissing Park Rd
Jeffersonville, IN 47130-5989
Phone
(502) 265-0491
Fax
(502) 222-8745
NPI assigned
Mar 14, 2008
Last updated
Aug 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Authorized official

Name
Mrs. Jacqueline J. Singer
Title
Office Manager
Phone
(502) 817-0927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01057489A IN Primary

Addresses

Primary practice location

2700 Vissing Park Rd
Jeffersonville, IN 47130-5989

Mailing address

PO Box 265
Jeffersonville, IN 47131-0265
Phone (502) 265-0491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080519000674 IN Part B Supplier - Clinic/Group Practice 3274602107 Receives reassigned benefits from 1 practitioner
Practice locations: Jeffersonville, IN
O20080609000792 KY Part B Supplier - Clinic/Group Practice 3274602107 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1639340953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471310265",
            "telephone_number": "502-265-0491",
            "fax_number": "502-222-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 VISSING PARK RD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305989",
            "telephone_number": "502-265-0491",
            "fax_number": "502-222-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFAQ MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "SINGER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-817-0927",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01057489A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.