NPIMap

Organization Active NPI

Indiana University Health West Hospital, Inc

  • Psychiatry Physician
  • Avon, IN
National Provider Identifier
1801815832
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
INDIANA UNIVERSITY HEALTH WEST HOSPITAL, INC
Practice address
1111 Ronald Reagan Pkwy
Building C
Avon, IN 46123-7085
Phone
(317) 217-3043
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Authorized official

Name
Matthew Bailey
Title
President, Ceo
Phone
(317) 217-3043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1111 Ronald Reagan Pkwy
Building C
Avon, IN 46123-7085

Mailing address

250 N Shadeland Ave
Suite 200
Indianapolis, IN 46219-4959
Phone (317) 962-4836

Other names 1

  • Clarian Health West, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120305000472 IN Part B Supplier - Clinic/Group Practice 1456257682 Receives reassigned benefits from 7 practitioners
Practice locations: Avon, IN

National Provider Directory

National Provider Directory

Locations

3276 Reliable Pkwy
Chicago, IL 60686

2232 Reliable Pkwy
Chicago, IL 60686

1111 Ronald Reagan Pkwy
Bldg C
Avon, IN 46123
Phone (317) 217-3043

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1801815832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-962-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 RONALD REAGAN PKWY",
            "address_2": "BUILDING C",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237085",
            "telephone_number": "317-217-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH WEST HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "317-217-3043"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarian Health West, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.