NPIMap

Organization Active NPI

Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
National Provider Identifier
1881655090
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ARNETT CLINIC, LLC
Practice address
2600 Greenbush St
Lafayette, IN 47904-2477
Phone
(765) 448-8000
NPI assigned
Mar 29, 2006
Last updated
Mar 16, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
ARNETT CLINIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Authorized official

Name
Alfonso Gatmaitan
Title
C.E.O.
Phone
(765) 448-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2600 Greenbush St
Lafayette, IN 47904-2477

Mailing address

PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000

Other identifiers 2

IdentifierTypeStateIssuer
000000377073OtherINANTHEM LAB NUMBER
100232370AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031125000119 IN Part B Supplier - Clinic/Group Practice 0749184380 Receives reassigned benefits from 709 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monticello, IN; Lafayette, IN; Otterbein, IN; West Lafayette, IN; Williamsport, IN; Frankfort, IN; Kokomo, IN; Avon, IN
O20040528000324 IN Part B Supplier - Independent Clinical Laboratory 0749184380 Practice locations: Lafayette, IN; West Lafayette, IN; Otterbein, IN; Monticello, IN; Frankfurt, IN

Other NPIs with the same Medicare PAC ID 1

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.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0362236Iu Health Arnett - Greenbush2600 Greenbush Street, Lafayette, IN 47904Certificate of waiverFeb 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Arnett Clinic LLC Lab12 organizations share this tax ID, including this one
Part of
Arnett Clinic LLC Lab

Other organizations with this tax ID 11

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

Member of 1

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

Locations

8016 Reliable Pkwy
Chicago, IL 60686

915 Mezzanine Dr
Ste A
Lafayette, IN 47905
Phone 7654488000 ext. 8639

938 Mezzanine Dr
Ste B
Lafayette, IN 47905
Phone (765) 742-1533

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 763

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 763

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1881655090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042477",
            "telephone_number": "765-448-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARNETT CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARNETT CLINIC, LLC",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "GATMAITAN",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "765-448-8000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM LAB NUMBER",
            "identifier": "000000377073",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100232370A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.