NPIMap

Organization Active NPI

Med 1St of Evansville, PC

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1881630739
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MED 1ST OF EVANSVILLE, PC
Practice address
1401 Washington Ave
Evansville, IN 47714-2056
Phone
(812) 473-4011
Fax
(812) 474-4581
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Authorized official

Name
Dr. Marvin Edward Poeling, D.C.
Title
President
Phone
(812) 473-4011

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1401 Washington Ave
Evansville, IN 47714-2056

Mailing address

PO Box 4506
Evansville, IN 47724-0506
Phone (812) 473-4011

Other identifiers 2

IdentifierTypeStateIssuer
156619OtherINMEDICARE OUTPATIENT REHAB FACILITY
5358340001OtherINDMERC PTAN

National Provider Directory

National Provider Directory

Locations

1401 Washington Ave
Evansville, IN 47714
Phone (812) 473-4011

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1881630739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4506",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477240506",
            "telephone_number": "812-473-4011",
            "fax_number": "812-474-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477142056",
            "telephone_number": "812-473-4011",
            "fax_number": "812-474-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED 1ST OF EVANSVILLE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "POELING",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-473-4011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OUTPATIENT REHAB FACILITY",
            "identifier": "156619",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC PTAN",
            "identifier": "5358340001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.