Organization Active NPI

Central Indiana Gastroenterology Group PC

  • Gastroenterology Physician
  • Anderson, IN
National Provider Identifier
1760576490
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CENTRAL INDIANA GASTROENTEROLOGY GROUP PC
Practice address
2020 Meridian Street
Suite 340
Anderson, IN 46016-4349
Phone
(765) 646-8477
Fax
(765) 649-0014
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Authorized official

Name
Jon M Maier, MD
Title
President
Phone
(765) 646-8477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X IN Primary

Addresses

Primary practice location

2020 Meridian Street
Suite 340
Anderson, IN 46016-4349

Mailing address

2020 Meridian Street
Suite 340
Anderson, IN 46016-4349
Phone (765) 646-8477

Other identifiers 4

IdentifierTypeStateIssuer
65936270MedicaidKY
CM2269OtherINMEDICARE RAILROAD
CE9088OtherINMEDICARE RAILROAD
100171370MedicaidIN

National Provider Directory

National Provider Directory

Locations

2350 S Dixon Rd
Ste 400
Kokomo, IN 46902
Phone (765) 455-9801

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1760576490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 MERIDIAN STREET",
            "address_2": "SUITE 340",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164349",
            "telephone_number": "765-646-8477",
            "fax_number": "765-649-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 MERIDIAN STREET",
            "address_2": "SUITE 340",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164349",
            "telephone_number": "765-646-8477",
            "fax_number": "765-649-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL INDIANA GASTROENTEROLOGY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "MAIER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-646-8477",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65936270",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CM2269",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CE9088",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100171370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.