Jan Jansen, M.D., PH.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

01000005 Issued in IN

Practice address

1600 Albany St
6 Tower
Beech Grove, IN 46107-1541

Phone

(317) 865-5500

Fax

(317) 782-6316

NPI assigned

Aug 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720192693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ALBANY ST",
            "address_2": "SUITE 911",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461071555",
            "telephone_number": "317-865-5500",
            "fax_number": "317-782-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ALBANY ST",
            "address_2": "6 TOWER",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461071541",
            "telephone_number": "317-865-5500",
            "fax_number": "317-782-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "JAN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01000005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Beech Grove, IN
• Providers in Beech Grove, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.