NPIMap

Organization Active NPI

Bell Trace Health and Living Center

  • Physical Therapist
  • Bloomington, IN
National Provider Identifier
1912155508
Registry record updated Oct 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05008832A Issued in IN
Legal business name
BELL TRACE HEALTH AND LIVING CENTER
Practice address
725 N Bell Trace Cir
Bloomington, IN 47408-4408
Phone
(812) 323-2858
Fax
(812) 323-2854
NPI assigned
Sep 8, 2008
Organization subpart
Yes
Parent organization
CARDON & ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 13, 2008

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

Authorized official

Name
Mr. Stephen Moore, M.D.
Title
Owner/Ceo
Phone
(812) 332-2265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 05008832A IN Primary

Addresses

Primary practice location

725 N Bell Trace Cir
Bloomington, IN 47408-4408

Mailing address

725 N Bell Trace Cir
Bloomington, IN 47408-4408
Phone (812) 323-2858

Other identifiers 1

IdentifierTypeStateIssuer
528301OtherINCOMMON ID PIN # FOR ANTHEM

National Provider Directory

National Provider Directory
Tax ID family
Bell Trace Health and Living Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223856000000",
    "number": "1912155508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N BELL TRACE CIR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474084408",
            "telephone_number": "812-323-2858",
            "fax_number": "812-323-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N BELL TRACE CIR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474084408",
            "telephone_number": "812-323-2858",
            "fax_number": "812-323-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELL TRACE HEALTH AND LIVING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARDON & ASSOCIATES",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-10-13",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "812-332-2265",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008832A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMON ID PIN # FOR ANTHEM",
            "identifier": "528301",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.