Active NPI
Montgomery County Free Clinic, Inc
- Community Health Clinic/Center
- Crawfordsville, IN
National Provider Identifier
1861826257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- Legal business name
- MONTGOMERY COUNTY FREE CLINIC, INC
- Practice address
- 816 Mill St
Crawfordsville, IN 47933-3443 - Phone
- (765) 362-3244
- NPI assigned
- Aug 21, 2013
- 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
- Dr. William Doemel
- Title
- Executive Director
- Phone
- (765) 376-9930
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | Primary |
Addresses
Primary practice location
816 Mill St
Crawfordsville, IN 47933-3443
Mailing address
PO Box 86
Crawfordsville, IN 47933-0086
Phone (765) 362-3244
Other names 1
- Dr. Mary Ludwig Free Clinic
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2063566 | Montgomery Co Free Clinic, Inc | Provider-performed microscopy | Aug 5, 2027 |
National Provider Directory
National Provider DirectoryLocations
816 Mill St
Crawfordsville, IN 47933
Phone (765) 362-3244
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Crawfordsville, IN
- NPI 1770251001
-
- Dentist
- Crawfordsville, IN
- NPI 1932952058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377043200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1377043200000",
"number": "1861826257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86",
"city": "CRAWFORDSVILLE",
"state": "IN",
"postal_code": "479330086",
"telephone_number": "765-362-3244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 MILL ST",
"city": "CRAWFORDSVILLE",
"state": "IN",
"postal_code": "479333443",
"telephone_number": "765-362-3244"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONTGOMERY COUNTY FREE CLINIC, INC",
"organizational_subpart": "NO",
"enumeration_date": "2013-08-21",
"last_updated": "2013-08-21",
"status": "A",
"authorized_official_last_name": "DOEMEL",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "765-376-9930",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Dr. Mary Ludwig Free Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Crawfordsville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.