Sullivan County Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SULLIVAN COUNTY INTERNAL MEDICINE LLC

Practice address

557 W Broadway St
Shelburn, IN 47879-1232

Phone

(812) 397-2440

Fax

(812) 397-0164

NPI assigned

Feb 7, 2019

Last updated

Sep 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Divyesh Purohit, M.D.NPI 1326028309

Title

M.D.

Phone

(812) 249-9904

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GHHGBD

Practitioners 1

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.

• Divyesh Purohit, MD

  • Internal Medicine Physician
  • Shelburn, IN
  • NPI 1326028309
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1871058529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3991 GOLF BAG LN",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478028145",
            "telephone_number": "812-249-9904",
            "fax_number": "812-316-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 W BROADWAY ST",
            "city": "SHELBURN",
            "state": "IN",
            "postal_code": "478791232",
            "telephone_number": "812-397-2440",
            "fax_number": "812-397-0164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Dugger",
            "state": "IN",
            "postal_code": "478485011",
            "country_code": "US",
            "telephone_number": "812-648-2231",
            "fax_number": "812-648-2968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SULLIVAN COUNTY INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-07",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "PUROHIT",
        "authorized_official_first_name": "DIVYESH",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "812-249-9904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Megan Butkiewicz, DT
• Kathy J Hugar, FNP
• Internal Medicine Nephrology, Inc.
• Divyesh Purohit, MD
• Terre Haute Pulmonary & Pediatric Clinic, LLC (Shelburn Medical Clinic)
• Union Associated Physicians Clinic, LLC
• Shanna Lynn White
• Emily Whitman, CCC-SLP

• Internal Medicine Physician in Shelburn, IN
• Providers in Shelburn, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.