NPIMap

Organization Active NPI

Mark S. Souder, M.D.

  • Family Medicine Physician
  • Auburn, IN
National Provider Identifier
1922287531
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARK S. SOUDER, M.D.
Practice address
1310 E 7TH St
Ste J
Auburn, IN 46706-2534
Phone
(260) 925-0305
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Mark Steven Souder, MD
Title
Owner
Phone
(260) 925-0305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1310 E 7TH St
Ste J
Auburn, IN 46706-2534

Mailing address

1310 E 7TH St
Ste J
Auburn, IN 46706-2534

Other identifiers 1

IdentifierTypeStateIssuer
200409320AMedicaidIN

Other names 1

  • Comprehensive Medical Care Other name

National Provider Directory

National Provider Directory

Locations

1300 E 7TH St
Auburn, IN 46706

1310 E 7th St
Ste J
Auburn, IN 46706
Phone (219) 925-0305

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1922287531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 E 7TH ST",
            "address_2": "STE J",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 E 7TH ST",
            "address_2": "STE J",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062534",
            "telephone_number": "260-925-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S. SOUDER, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "SOUDER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-925-0305",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200409320A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Medical Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Auburn, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.