NPIMap

Organization Active NPI

Cep America - Neurology PC

  • Neurology Physician
  • Clinton, IN
National Provider Identifier
1639788250
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CEP AMERICA - NEUROLOGY PC
Practice address
801 S Main St
Clinton, IN 47842-2261
Phone
(765) 832-1234
NPI assigned
Jul 29, 2020
Last updated
Jul 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
David Birdsall, MD
Title
Vice President
Phone
(510) 350-2680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

801 S Main St
Clinton, IN 47842-2261

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 350-2680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, KY, TX, IN, TN, FL, MI, GA, NJ, DE10 enrollments

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
O20170622001181 CA Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 145 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20201019003055 KY Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 1 practitioner
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY
O20201020001764 TX Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 1 practitioner
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cypress, TX
O20201022000096 IN Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 30 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, IN; Crown Point, IN; Terre Haute, IN
O20221021001901 TN Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 2 practitioners
5 other NPIs on this enrollment
Practice locations: Columbia, TN; Friendsville, TN
O20230912001754 FL Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 19 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alachua, FL; Lutz, FL; Saint Augustine, FL; Saint Johns, FL; Santa Fe, FL; St Augustine, FL
O20251203003098 MI Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Canton, MI
O20251230002913 GA Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 1 practitioner
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alpharetta, GA; Atlanta, GA
O20260107000173 NJ Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 1 practitioner
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Union City, NJ
O20260408004235 DE Part B Supplier - Clinic/Group Practice 3971871500 Receives reassigned benefits from 1 practitioner
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, DE

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1639788250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-350-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MAIN ST",
            "city": "CLINTON",
            "state": "IN",
            "postal_code": "478422261",
            "telephone_number": "765-832-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEP AMERICA - NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "BIRDSALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "510-350-2680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.