Active NPI
Indiana Physician Management-Jennings, LLC
- Emergency Medicine Physician
- North Vernon, IN
National Provider Identifier
1861783326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201032430A | Medicaid | IN |
National Provider Directory
National Provider DirectoryLocations
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.