Organization Active NPI

Indiana Physician Management-Jennings, LLC

  • Emergency Medicine Physician
  • North Vernon, IN
National Provider Identifier
1861783326
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
INDIANA PHYSICIAN MANAGEMENT-JENNINGS, LLC
Practice address
301 Henry St
North Vernon, IN 47265
Phone
(812) 352-4200
Fax
(317) 870-0499
NPI assigned
May 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

Name
Stewart Bick, M.D.
Title
President
Phone
(317) 338-5053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

301 Henry St
North Vernon, IN 47265

Mailing address

7023 Solution Ctr
Chicago, IL 60677-0001
Phone (866) 588-6897

Other identifiers 1

IdentifierTypeStateIssuer
201032430AMedicaidIN

National Provider Directory

National Provider Directory

Locations

7023 Solutions Ctr
Chicago, IL 60677

Practitioners & affiliated clinicians

Practitioners 2

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": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1861783326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7023 SOLUTION CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770001",
            "telephone_number": "866-588-6897",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HENRY ST",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "47265",
            "telephone_number": "812-352-4200",
            "fax_number": "317-870-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA PHYSICIAN MANAGEMENT-JENNINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "BICK",
        "authorized_official_first_name": "STEWART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-338-5053",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201032430A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Vernon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.