Integrated Medical Care and Nephrology LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

01061402A Issued in IN

Legal business name

INTEGRATED MEDICAL CARE AND NEPHROLOGY LLC

Doing business as

IMCN

Practice address

6925 Shore Ter
Indianapolis, IN 46254-4675

Phone

(317) 290-8288

Fax

(317) 290-8801

NPI assigned

Apr 16, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Bryant King, MD

Title

Owner

Phone

(317) 757-9731

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• IMCN Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1679916001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6925 SHORE TER",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462544675",
            "telephone_number": "317-290-8288",
            "fax_number": "317-290-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6925 SHORE TER",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462544675",
            "telephone_number": "317-290-8288",
            "fax_number": "317-290-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL CARE AND NEPHROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "BRYANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-757-9731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IN",
            "license": "01061402A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679916001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMCN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medical Specialty Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Medical Specialty Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.