NPIMap

Organization Active NPI

Community Hospitals of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1689602047
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY HOSPITALS OF INDIANA INC
Practice address
10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2697
Phone
(317) 355-5717
Fax
(317) 355-3760
NPI assigned
Jun 28, 2006
Last updated
Oct 14, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPITALS OF INDIANA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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) 355-4887

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IN Primary
Obstetrics & Gynecology Physician 207V00000X IN
Pediatrics Physician 208000000X IN

Addresses

Primary practice location

10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2697

Mailing address

3826 Solutions Ctr
Chicago, IL 60677-3008
Phone (317) 355-5837

Other identifiers 3

IdentifierTypeStateIssuer
100236570AMedicaidIN
5085061OtherINAETNA
CA1777OtherINRAILROAD MEDICARE

Other names 1

  • Community Group Family Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000554 IN Part B Supplier - Clinic/Group Practice 1850203977 Receives reassigned benefits from 282 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN; Greenfield, IN; Kokomo, IN; Shelbyville, IN; Greenwood, IN; Anderson, IN

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
David Felkins MD

Locations

10122 E 10th St
Indianapolis, IN 46229
Phone (317) 355-2132

10122 E 10th St
#2
Indianapolis, IN 46229
Phone (317) 355-3355

Practitioners & affiliated clinicians

Practitioners 8

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": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1689602047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3826 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606773008",
            "telephone_number": "317-355-5837",
            "fax_number": "317-355-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292697",
            "telephone_number": "317-355-5717",
            "fax_number": "317-355-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITALS OF INDIANA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPITALS OF INDIANA INC",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "KIRKHAM",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-355-4887"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100236570A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5085061",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA1777",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Group Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 14, 2011; 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.

Verify at the official NPI Registry.