NPIMap

Organization Active NPI

Mid State Logansport Ed Physicians

  • Emergency Medicine Physician
  • Logansport, IN
National Provider Identifier
1831233287
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MID STATE LOGANSPORT ED PHYSICIANS
Practice address
1101 Michigan Ave
Logansport, IN 46947-1528
Phone
(574) 753-1475
NPI assigned
Feb 19, 2007
Last updated
Dec 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Dr. Eddie M Stone, M.D.
Title
President - Owner
Phone
(214) 712-2000

Specialties & licenses 1

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

Addresses

Primary practice location

1101 Michigan Ave
Logansport, IN 46947-1528

Mailing address

1717 Main St
Suite 5200
Dallas, TX 75201-4612
Phone (214) 712-2000

Other identifiers 2

IdentifierTypeStateIssuer
200869800AMedicaidIN
000000514965OtherINBLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1831233287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "address_2": "SUITE 5200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014612",
            "telephone_number": "214-712-2000",
            "fax_number": "214-712-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471528",
            "telephone_number": "574-753-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID STATE LOGANSPORT ED PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT - OWNER",
        "authorized_official_telephone_number": "214-712-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200869800A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000000514965",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.