Organization Active NPI

American Health Network of Indiana, LLC

  • Neurology Physician
  • Carmel, IN
National Provider Identifier
1699961037
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Practice address
12425 Old Meridian St
Suite a-2
Carmel, IN 46032-8724
Phone
(317) 848-1402
NPI assigned
Sep 19, 2007
Last updated
Feb 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Authorized official

Name
Ben H Park, MD
Title
President/Ceo
Phone
(317) 580-6314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

12425 Old Meridian St
Suite a-2
Carmel, IN 46032-8724

Mailing address

2330 S Dixon Rd
Kokomo, IN 46902-6411
Phone (765) 455-5400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000691 IN Part B Supplier - Clinic/Group Practice 9830093533 Receives reassigned benefits from 230 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Ahn Georgetown

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1699961037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 S DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026411",
            "telephone_number": "765-455-5400",
            "fax_number": "765-865-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 OLD MERIDIAN ST",
            "address_2": "SUITE A-2",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328724",
            "telephone_number": "317-848-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN HEALTH NETWORK OF INDIANA, LLC",
        "enumeration_date": "2007-09-19",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "317-580-6314",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.