Organization Active NPI

Otolaryngology Specialty Care, LLC

  • Otolaryngology Physician
  • Columbus, IN
National Provider Identifier
1730440108
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
OTOLARYNGOLOGY SPECIALTY CARE, LLC
Practice address
2345 Northpark Dr
Columbus, IN 47203-4473
Phone
(812) 669-1490
Fax
(812) 669-1491
NPI assigned
Jun 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Dr. Christopher E Stevens, M.D.NPI 1093712291
Title
Owner
Phone
(812) 669-1490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2345 Northpark Dr
Columbus, IN 47203-4473

Mailing address

2345 Northpark Dr
Columbus, IN 47203-4473
Phone (812) 669-1490

Other identifiers 1

IdentifierTypeStateIssuer
201078850AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120710000411 IN Part B Supplier - Clinic/Group Practice 2264697630 Receives reassigned benefits from 3 practitioners
Practice locations: Columbus, IN; Greensburg, IN; Batesville, IN

National Provider Directory

National Provider Directory

Locations

2345 Northpark Dr
Columbus, IN 47203
Phone (812) 372-8293

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26285/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1338508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1730440108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 NORTHPARK DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472034473",
            "telephone_number": "812-669-1490",
            "fax_number": "812-669-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 NORTHPARK DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472034473",
            "telephone_number": "812-669-1490",
            "fax_number": "812-669-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTOLARYNGOLOGY SPECIALTY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-01",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-669-1490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201078850A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.