NPIMap

Organization Active NPI

American Health Network of Indiana, LLC

  • Durable Medical Equipment & Medical Supplies
  • Kokomo, IN
National Provider Identifier
1669567418
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Practice address
2330 S. Dixon Road
Kokomo, IN 46902
Phone
(765) 455-5400
Fax
(765) 865-3912
NPI assigned
Oct 4, 2006
Last updated
Jun 22, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Authorized official

Name
Ben H Park, MD
Title
President and Ceo
Phone
(317) 580-6307

Specialties & licenses 1

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

Addresses

Primary practice location

2330 S. Dixon Road
Kokomo, IN 46902

Mailing address

2330 S. Dixon Road
Kokomo, IN 46902
Phone (765) 455-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930027325 IN DME Supplier - Multi-Specialty - Physician 9830093533 Practice locations: Kokomo, IN

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Ahn Georgetown33 organizations share this tax ID, including this one
Part of
Ahn Georgetown

Other organizations with this tax ID 32

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

View all 32

Member of 1

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Physicians Medical Center LLCNew Albany, IN, CCN 150172 Hospital 5% Or Greater Indirect Ownership Interest (26.71%) Dec 14, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498089600000",
    "number": "1669567418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 S. DIXON ROAD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "46902",
            "telephone_number": "765-455-5400",
            "fax_number": "765-865-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S. DIXON ROAD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "46902",
            "telephone_number": "765-455-5400",
            "fax_number": "765-865-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-06-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "317-580-6307",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.