Organization Active NPI

Community Hospitals of Indiana Inc

Doing business as Fall Creek Family Medicine

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1679598171
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200869330MedicaidIN

Other names 1

  • Fall Creek Family Medicine Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0699183Fall Creek Family Medicine9560 E 59TH St, Indianapolis, IN 46216Certificate of waiverMar 24, 2028

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": "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

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.

Verify at the official NPI Registry.