Active NPI
Community Hospitals of Indiana Inc
Doing business as Fall Creek Family Medicine
- Family Medicine Physician
- Indianapolis, IN
National Provider Identifier
1679598171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- COMMUNITY HOSPITALS OF INDIANA INC
- Doing business as
- Fall Creek Family Medicine
- Practice address
- 9560 E 59TH St
Indianapolis, IN 46216-1010 - Phone
- (317) 621-1700
- Fax
- (317) 621-1711
- NPI assigned
- Jul 13, 2006
- Last updated
- Sep 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffery Kirkham
- Title
- Cfo
- Phone
- (317) 355-5822
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
9560 E 59TH St
Indianapolis, IN 46216-1010
Mailing address
9560 E 59TH St
Indianapolis, IN 46216-1010
Phone (317) 621-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200869330 | Medicaid | IN |
Other names 1
- Fall Creek Family Medicine
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0699183 | Fall Creek Family Medicine | Certificate of waiver | Mar 24, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Orthopaedic Surgery Physician
- Indianapolis, IN
- NPI 1891729463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1253059200000",
"number": "1679598171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9560 E 59TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462161010",
"telephone_number": "317-621-1700",
"fax_number": "317-621-1711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9560 E 59TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462161010",
"telephone_number": "317-621-1700",
"fax_number": "317-621-1711"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY HOSPITALS OF INDIANA INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-13",
"last_updated": "2009-09-16",
"status": "A",
"authorized_official_last_name": "KIRKHAM",
"authorized_official_first_name": "JEFFERY",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "317-355-5822"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200869330",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Fall Creek Family Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Indianapolis, IN
- Community Hospitals of Indiana Inc (Arnold Brown MD)
- Community Hospitals of Indiana Inc (Felkins Metzler)
- Community Hospitals of Indiana Inc (Community Sleep Specialist)
- Community Hospitals of Indiana Inc (Touchpoint)
- Community Hospitals of Indiana Inc (Northside Womens Care)
- Community Hospitals of Indiana Inc
- Community Hospitals of Indiana Inc (Post Road Family Medicine)
- Community Hospitals of Indiana Inc (Community Breast Care)
- Community Hospitals of Indiana Inc (Geist Family Medicine)
- Community Hospitals of Indiana Inc (Rudolph Rouhana MD)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.