NPIMap

Organization Active NPI

ENT Associates of Southern Indiana, P.C.

  • Otolaryngology Physician
  • Bloomington, IN
National Provider Identifier
1699854745
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
50000616A Issued in IN
Legal business name
ENT ASSOCIATES OF SOUTHERN INDIANA, P.C.
Practice address
2920 McIntyre Dr
Suite 350
Bloomington, IN 47403-4221
Phone
(812) 332-2226
Fax
(812) 339-2934
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Denise Lynn West
Title
Office Manager
Phone
(812) 332-2226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 50000616A IN Primary

Addresses

Primary practice location

2920 McIntyre Dr
Suite 350
Bloomington, IN 47403-4221

Mailing address

2920 McIntyre Dr
Suite 350
Bloomington, IN 47403-4221
Phone (812) 332-2226

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699854745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 MCINTYRE DR",
            "address_2": "SUITE 350",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034221",
            "telephone_number": "812-332-2226",
            "fax_number": "812-339-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MCINTYRE DR",
            "address_2": "SUITE 350",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034221",
            "telephone_number": "812-332-2226",
            "fax_number": "812-339-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT ASSOCIATES OF SOUTHERN INDIANA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "812-332-2226"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "50000616A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.