NPIMap

Organization Active NPI

St. Vincent Medical Group, Inc.

Doing business as Ascension Medical Group St. Vincent

  • Occupational Medicine Physician
  • Kokomo, IN
National Provider Identifier
1851036339
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
ST. VINCENT MEDICAL GROUP, INC.
Doing business as
Ascension Medical Group St. Vincent
Practice address
138 N Dixon Rd
Kokomo, IN 46901-4154
Phone
(765) 236-8282
NPI assigned
Apr 29, 2022
Last updated
Apr 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Authorized official

Name
Brian Morris
Title
Cfo
Phone
(317) 338-6234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X NU Primary

Addresses

Primary practice location

138 N Dixon Rd
Kokomo, IN 46901-4154

Mailing address

250 W 96TH St Ste 520
Indianapolis, IN 46260-1317

Other names 2

  • ASCENSION MEDICAL GROUP ST. VINCENT Doing business as
  • WELLNESS - DIXON ROAD Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0358535Ascension Medical Group St Vincent -138 North Dixon Rd, Kokomo, IN 46901Certificate of waiverJun 25, 2028

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Medical Group Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1851036339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST STE 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014154",
            "telephone_number": "765-236-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-338-6234"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASCENSION MEDICAL GROUP ST. VINCENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WELLNESS - DIXON ROAD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.