Monticello Medical Center, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MONTICELLO MEDICAL CENTER, LLC

Practice address

826 N 6TH St
Monticello, IN 47960-1752

Phone

(574) 583-3333

Fax

(574) 583-4785

NPI assigned

Jan 16, 2007

Organization subpart

Yes

Parent organization

NOAs reported in NPPES

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

Authorized official

Name

Dr. Charles R. Tribbett, M.D.

Title

Owner

Phone

(574) 583-3333

Specialties & licenses 4

Addresses

Other identifiers 2

Part of

Cass County Medical Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Tribbett Family Medicine, LLC

  • Family Medicine Physician
  • Monticello, IN
  • NPI 1427416361

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1871645531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 N 6TH ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479601752",
            "telephone_number": "574-583-3333",
            "fax_number": "574-583-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N 6TH ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479601752",
            "telephone_number": "574-583-3333",
            "fax_number": "574-583-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "TRIBBETT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-583-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200495560",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000099180A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Mikels, OD
• Kylee Miller
• William J Misenheimer, D.C.
• Monticello Eye Center, P.C.
• Monticello Medical Center, LLC
• Monticello Podiatry LLC
• Monticello Podiatry LLC
• Monticello Women'S Clinic
• Shanda Mossholder
• Sharon D Musall, ANP

• Rural Health Clinic/Center in Monticello, IN
• Providers in Monticello, IN by specialty
• Rural Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.