NPIMap

Organization Active NPI

Indiana University Health Bedford, Inc

  • Clinical Pathology Physician
  • Bedford, IN
National Provider Identifier
1871036962
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
Legal business name
INDIANA UNIVERSITY HEALTH BEDFORD, INC
Practice address
2900 16TH St
Bedford, IN 47421-3510
Phone
(812) 275-1200
Fax
(812) 275-1231
NPI assigned
Nov 22, 2016
Last updated
Nov 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Authorized official

Name
Mr. Brad Dykes
Title
President
Phone
(812) 275-1200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X
Clinical Pathology Physician 207ZC0006X Primary

Addresses

Primary practice location

2900 16TH St
Bedford, IN 47421-3510

Mailing address

2900 16TH St
Bedford, IN 47421-3510
Phone (812) 275-1200

Other names 1

  • IU Health Bedford Hospital Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031122000022 IN Part B Supplier - Clinic/Group Practice 2668383092 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Bedford, IN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Indiana University HLTH Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2699 Solutions Ctr
Chicago, IL 60677

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1871036962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 16TH ST",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213510",
            "telephone_number": "812-275-1200",
            "fax_number": "812-275-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 16TH ST",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213510",
            "telephone_number": "812-275-1200",
            "fax_number": "812-275-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH BEDFORD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "DYKES",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-275-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Health Bedford Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bedford, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.