NPIMap

Organization Active NPI

Digestive Diseases Center

  • Gastroenterology Physician
  • Bloomington, IN
National Provider Identifier
1831394766
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01031299A Issued in IN
Legal business name
DIGESTIVE DISEASES CENTER
Practice address
2920 McIntyre Dr Ste 310
Bloomington, IN 47403-4215
Phone
(812) 331-0233
Fax
(812) 331-0287
NPI assigned
Jun 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Dr. Richard A Weddle, MDNPI 1356327829
Title
President
Phone
(812) 331-0233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 01031299A IN Primary

Addresses

Primary practice location

2920 McIntyre Dr Ste 310
Bloomington, IN 47403-4215

Mailing address

2920 S McIntyre Dr Ste 310
Bloomington, IN 47403-4215
Phone (812) 331-0233

Other identifiers 2

IdentifierTypeStateIssuer
200890860AMedicaidIN
100184520MedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1831394766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 S MCINTYRE DR STE 310",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034215",
            "telephone_number": "812-331-0233",
            "fax_number": "812-331-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MCINTYRE DR STE 310",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034215",
            "telephone_number": "812-331-0233",
            "fax_number": "812-331-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "WEDDLE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-331-0233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01031299A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200890860A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100184520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.