NPIMap

Organization Active NPI

St. Vincent Medical Group, Inc.

  • Occupational Medicine Physician
  • Salem, IN
National Provider Identifier
1669117149
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
ST. VINCENT MEDICAL GROUP, INC.
Practice address
102 Connie Ave Ste 204
Salem, IN 47167-2313
Phone
(812) 755-4443
NPI assigned
Apr 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Authorized official

Name
Brian Morris
Title
Cfo
Phone
(317) 338-6234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083X0100X Primary

Addresses

Primary practice location

102 Connie Ave Ste 204
Salem, IN 47167-2313

Mailing address

250 W 96TH St Ste 520
Indianapolis, IN 46260-1317

Other names 2

  • ASCENSION MEDICAL GROUP ST. VINCENT Doing business as
  • WELLNESS - SALEM Other name

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Medical Group Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1669117149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST STE 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CONNIE AVE STE 204",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471672313",
            "telephone_number": "812-755-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-338-6234"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASCENSION MEDICAL GROUP ST. VINCENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WELLNESS - SALEM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salem, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.