NPIMap

Organization Active NPI

Southern Indiana Community Health Care, Inc

Doing business as Crawford County Family Health Care

  • Family Medicine Physician
  • Marengo, IN
National Provider Identifier
1700909348
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC
Doing business as
Crawford County Family Health Care
Practice address
5604 E White Oak LN
Marengo, IN 47140-8413
Phone
(812) 365-3221
Fax
(812) 365-9502
NPI assigned
Apr 9, 2007
Last updated
Aug 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Authorized official

Name
Tonya M Jones, CPB
Title
Billing Manager
Phone
(812) 723-7119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5604 E White Oak LN
Marengo, IN 47140-8413

Mailing address

420 W Longest St
PO Box 270
Paoli, IN 47454-8821
Phone (812) 723-7119

Other names 1

  • Crawford County Family Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000541 IN Part B Supplier - Clinic/Group Practice 5799694360 Receives reassigned benefits from 37 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orleans, IN; Paoli, IN

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1700909348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W LONGEST ST",
            "address_2": "PO BOX 270",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474548821",
            "telephone_number": "812-723-7119",
            "fax_number": "812-723-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 E WHITE OAK LN",
            "city": "MARENGO",
            "state": "IN",
            "postal_code": "471408413",
            "telephone_number": "812-365-3221",
            "fax_number": "812-365-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "812-723-7119",
        "authorized_official_credential": "CPB"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crawford County Family Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crawford County Family Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marengo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.