NPIMap

Organization Active NPI

Indiana Emergency Physicians LLP

  • Emergency Medicine Physician
  • Charlestown, IN
National Provider Identifier
1750613485
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
INDIANA EMERGENCY PHYSICIANS LLP
Practice address
2200 Market Street
Charlestown, IN 47111-0069
Phone
(812) 256-3301
NPI assigned
Feb 5, 2010
Last updated
Jun 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Authorized official

Name
Dr. Derik K KingNPI 1376560912
Title
LLP Managing Partner
Phone
(866) 916-5259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X IN Primary

Addresses

Primary practice location

2200 Market Street
Charlestown, IN 47111-0069

Mailing address

75 Remit Dr # 1122
Chicago, IL 60675-1122
Phone (866) 916-5259

Other identifiers 3

IdentifierTypeStateIssuer
7100116010MedicaidKY
200173120EMedicaidIN
1750613485MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1265328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1750613485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DR # 1122",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751122",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MARKET STREET",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471110069",
            "telephone_number": "812-256-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA EMERGENCY PHYSICIANS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DERIK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LLP MANAGING PARTNER",
        "authorized_official_telephone_number": "866-916-5259",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100116010",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200173120E",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750613485",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.