Michael E Harper, MD
Individual provider Active NPI Family Medicine Physician · Tipton, IN
NPI 1790774032 · NPPES record last updated Sep 25, 2014
Key facts
- NPI
- 1790774032
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01028602A (IN)
- Practice address
- 410 Fairground Rd
Tipton, IN 46072-9596 - Phone
- (765) 675-8764
- Fax
- (765) 675-6846
- NPI assigned
- Oct 19, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Owned or controlled facilities with NPI records 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Iu Health Tipton Hospital |
Hospital | Corporate Director | Mar 24, 2022 |
| Iu Health Tipton Hospital |
Hospital | Corporate Director | Mar 24, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050325000674 | IN | Practitioner - Family Practice | 2163478710 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01028602 | IN | MD | Family Medicine Physician |
| 01028602A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Care Associates, Inc | Current |
Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients | |
| Michael E Harper MD PC | Family Medicine | Past |
Accepting new patients |
Locations
5208 Reliable Pkwy
Chicago, IL 60686
1115 Ronald Reagan Pkwy
Ste 364
Avon, IN 46123
Phone (317) 217-2636
1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000
250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836
1000 S Main St
Tipton, IN 46072
Phone (765) 675-8500
410 Fairgrounds Rd
Tipton, IN 46072
Phone (765) 675-3872
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01028602 | IN | |
| Family Medicine Physician | 207Q00000X | 01028602A | IN | Yes |
Addresses
Primary practice location
410 Fairground Rd
Tipton, IN 46072-9596
Mailing address
250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219-4959
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100233700A | Medicaid | IN |
Other providers in Tipton, IN
- Adam T Garner
- GG II Indiana, LLC
- Justin Griswold
- Ky L Groover
- Harper Family Eye Care LLC
- Robert Michael Harper
- Healthwise Dental, Inc.
- Erin C Herndon
- Catherine Herod
- Vassilina Viktorova Hinova
All providers in Tipton, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.