Northeast Indiana Urology PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTHEAST INDIANA UROLOGY PC

Practice address

304 N Townline Rd
Lagrange, IN 46761-1319

Phone

(260) 436-6667

Fax

(260) 469-7437

NPI assigned

Feb 4, 2008

Organization subpart

No

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

Authorized official

Name

John B Brinkman

Title

MD

Phone

(260) 436-6667

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1861670754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 E DUPONT RD",
            "address_2": "SUITE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-436-6667",
            "fax_number": "260-469-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N TOWNLINE RD",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467611319",
            "telephone_number": "260-436-6667",
            "fax_number": "260-469-7437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST INDIANA UROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "BRINKMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "260-436-6667"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamran Mushtaq, MD
• Sumant Nanduri, MBBS, MD
• Craig Lee Nelson, DDS
• Lilee Nguyen, PA-C
• Kerri Lauren Nickles, ED.S.
• Northeast Internal Medicine Associates, PC
• Northeast Internal Medicine Associates, PC
• Leann Marie Parker, NP
• Kyle James Phillip
• Lisa N Piper, MD

• All providers in Lagrange, IN
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.