NPIMap

Organization Active NPI

Terre Haute Neurosurgical & Spine Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Terre Haute, IN
National Provider Identifier
1649486036
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
01057579A Issued in IN
Legal business name
TERRE HAUTE NEUROSURGICAL & SPINE CLINIC, LLC
Practice address
1530 N 7TH St
Suite 107
Terre Haute, IN 47807-1057
Phone
(812) 238-4900
Fax
(812) 238-4921
NPI assigned
May 15, 2007
Last updated
Feb 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. G Andrew Wilson Jr., M.D.
Title
Owner
Phone
(812) 238-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 01057579A IN Primary

Addresses

Primary practice location

1530 N 7TH St
Suite 107
Terre Haute, IN 47807-1057

Mailing address

1530 N 7TH St
Suite 107
Terre Haute, IN 47807-1057
Phone (812) 238-4900

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": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1649486036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 N 7TH ST",
            "address_2": "SUITE 107",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071057",
            "telephone_number": "812-238-4900",
            "fax_number": "812-238-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N 7TH ST",
            "address_2": "SUITE 107",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071057",
            "telephone_number": "812-238-4900",
            "fax_number": "812-238-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRE HAUTE NEUROSURGICAL & SPINE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-238-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "01057579A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.