Active NPI
American Health Network of Indiana, LLC
- Non-Pharmacy Dispensing Site
- Winchester, IN
National Provider Identifier
1679502686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-Pharmacy Dispensing Site
- Legal business name
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
- Practice address
- 190 Inks Drive
Winchester, IN 47394-8283 - Phone
- (317) 580-6429
- NPI assigned
- Jul 2, 2006
- Last updated
- Mar 24, 2014
- Organization subpart
- Yes
- Parent organization
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ben H. Park, M.D.
- Title
- President and Ceo
- Phone
- (317) 580-6314
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Pharmacy Dispensing Site | 332900000X | Primary |
Addresses
Primary practice location
190 Inks Drive
Winchester, IN 47394-8283
Mailing address
190 Inks Drive
Winchester, IN 47394-8283
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031124000691 | IN | Part B Supplier - Clinic/Group Practice | 9830093533 |
Receives reassigned benefits from 230 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- American Health Network of Indiana LLC
Locations
190 Inks Dr
Winchester, IN 47394
Phone (317) 580-6429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1395619200000",
"number": "1679502686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 INKS DRIVE",
"city": "WINCHESTER",
"state": "IN",
"postal_code": "473948283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 INKS DRIVE",
"city": "WINCHESTER",
"state": "IN",
"postal_code": "473948283",
"telephone_number": "317-580-6429"
}
],
"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": "2006-07-02",
"last_updated": "2014-03-24",
"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": "317-580-6314",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "332900000X",
"taxonomy_group": "",
"desc": "Non-Pharmacy Dispensing Site",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winchester, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.