NPIMap

Organization Active NPI

Woodway Internal Medicine PC

  • Internal Medicine Physician
  • Muncie, IN
National Provider Identifier
1730509050
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WOODWAY INTERNAL MEDICINE PC
Practice address
4000 W Woodway Dr
Muncie, IN 47304-4264
Phone
(765) 213-4950
Fax
(765) 741-4658
NPI assigned
Apr 25, 2014
Last updated
Sep 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Mr. Scott A Himes, MBA
Title
Practice Manager
Phone
(765) 213-4950

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X IN
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

4000 W Woodway Dr
Muncie, IN 47304-4264

Mailing address

4000 W Woodway Dr
Muncie, IN 47304-4264
Phone (765) 213-4950

Other names 1

  • Woodway Medical Group PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140603001195 IN Part B Supplier - Clinic/Group Practice 9830312263 Receives reassigned benefits from 6 practitioners
Practice locations: Muncie, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0359955Woodway Internal Medicine4000 W Woodway Dr, Muncie, IN 47304AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

4000 W Woodway Dr
Muncie, IN 47304
Phone (765) 213-4950

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27103/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

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": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1730509050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W WOODWAY DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044264",
            "telephone_number": "765-213-4950",
            "fax_number": "765-741-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W WOODWAY DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044264",
            "telephone_number": "765-213-4950",
            "fax_number": "765-741-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWAY INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "HIMES",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "765-213-4950",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodway Medical Group PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Woodway Medical Group PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.