Paolo C Giacomini, M.D. PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01038356 Issued in IN

Legal business name

PAOLO C GIACOMINI, M.D. PC

Doing business as

Ash Street Clinic

Practice address

400 Ash St
Wabash, IN 46992-1954

Phone

(260) 563-8875

Fax

(260) 569-9803

NPI assigned

Jul 22, 2008

Last updated

Jul 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paolo C. Giacomini C Giacomini, M.D.

Title

Owner

Phone

(260) 563-8875

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ash Street Clinic Doing business as

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1790940476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASH ST",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921954",
            "telephone_number": "260-563-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ASH ST",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921954",
            "telephone_number": "260-563-8875",
            "fax_number": "260-569-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAOLO C GIACOMINI, M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "GIACOMINI",
        "authorized_official_first_name": "PAOLO C. GIACOMINI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-563-8875",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01038356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200042050A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ash Street Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Wabash, IN
• Providers in Wabash, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.