Active NPI
Adam Jay Patrick, M.D.
- Internal Medicine Physician
- Marion, IN
National Provider Identifier
1679746127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01068296A
- Practice address
- 1406 W Bella Dr
Marion, IN 46953-5229 - Phone
- (765) 660-7720
- Fax
- (765) 662-4493
- NPI assigned
- Apr 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01068296A | IN | Primary |
Addresses
Primary practice location
1406 W Bella Dr
Marion, IN 46953-5229
Mailing address
330 N Wabash
Ste G20
Marion, IN 46952-2600
Phone (765) 660-7616
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000933044 | Other | IN | ANTHEM |
| 201016230 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | adam.patrick@mgh.eclinicaldirectplus.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- adam.patrick@mgh.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1679746127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N WABASH",
"address_2": "STE G20",
"city": "MARION",
"state": "IN",
"postal_code": "469522600",
"telephone_number": "765-660-7616",
"fax_number": "765-651-7313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 W BELLA DR",
"city": "MARION",
"state": "IN",
"postal_code": "469535229",
"telephone_number": "765-660-7720",
"fax_number": "765-662-4493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "ADAM",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-04",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01068296A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000933044",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201016230",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "adam.patrick@mgh.eclinicaldirectplus.com",
"affiliation": "N",
"address_1": "1406 W Bella Dr",
"city": "Marion",
"state": "IN",
"country_code": "US",
"postal_code": "469535229",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.