Allied Physicians of Michiana, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ALLIED PHYSICIANS OF MICHIANA, LLC

Doing business as

Allied Bone and Joint

Practice address

1919 Lake Ave
Suite 107B
Plymouth, IN 46563-7830

Phone

(574) 540-2500

Fax

(574) 540-2570

NPI assigned

Oct 15, 2014

Last updated

Oct 15, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

ALLIED PHYSICIANS OF MICHIANA, LLCAs reported in NPPES

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

Authorized official

Name

Shery A. Roussarie

Title

Ceo

Phone

(574) 251-2100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Allied Bone and Joint Doing business as

Part of

Allied Physicians of Michiana LLC

Locations

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1902200298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "address_2": "SUITE 230",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-251-2100",
            "fax_number": "574-251-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LAKE AVE",
            "address_2": "SUITE 107B",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637830",
            "telephone_number": "574-540-2500",
            "fax_number": "574-540-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIED PHYSICIANS OF MICHIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLIED PHYSICIANS OF MICHIANA, LLC",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "ROUSSARIE",
        "authorized_official_first_name": "SHERY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-251-2100"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200962980",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allied Bone and Joint",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Allied Physicians of Michiana, LLC (Allied Bone and Joint)
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• Durable Medical Equipment & Medical Supplies in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.