NPIMap

Organization Active NPI

Floyd Memorial Medical Group LLC

  • Family Medicine Physician
  • New Albany, IN
National Provider Identifier
1730482779
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FLOYD MEMORIAL MEDICAL GROUP LLC
Practice address
1425 State St Ste 210
New Albany, IN 47150-4977
Phone
(812) 981-6511
Fax
(812) 981-6566
NPI assigned
Dec 14, 2010
Last updated
Dec 14, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
FLOYD MEMORIAL HOSPITAL & HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Kim Mardis
Title
Credentialing
Phone
(270) 765-3886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1425 State St Ste 210
New Albany, IN 47150-4977

Mailing address

1425 State St Ste 210
New Albany, IN 47150-4977
Phone (812) 981-6511

National Provider Directory

National Provider Directory
Tax ID family
Floyd Memorial Medical Group LLC3 organizations share this tax ID, including this one
Part of
Floyd Memorial Hospital He

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1425 State St
Ste 210
New Albany, IN 47150
Phone (812) 949-1002

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1730482779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 STATE ST STE 210",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504977",
            "telephone_number": "812-981-6511",
            "fax_number": "812-981-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 STATE ST STE 210",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504977",
            "telephone_number": "812-981-6511",
            "fax_number": "812-981-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOYD MEMORIAL MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLOYD MEMORIAL HOSPITAL & HEALTH SERVICES",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "MARDIS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "270-765-3886"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.