Individual provider Active NPI

Adam D Will, MD

  • Pediatrics Physician
  • Berne, IN
National Provider Identifier
1932363587
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01071052 Issued in IN
Practice address
1521 W Main St Ste 1
Berne, IN 46711-1797
Phone
(260) 589-2312
Fax
(260) 589-3941
NPI assigned
Jul 14, 2008
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01071052 IN
Pediatrics Physician 208000000X 01071052 IN Primary

Addresses

Primary practice location

1521 W Main St Ste 1
Berne, IN 46711-1797

Mailing address

1521 W Main St Ste 1
Berne, IN 46711-1797
Phone (260) 589-2312

Other identifiers 1

IdentifierTypeStateIssuer
201037140MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120613000065 IN Practitioner - Pediatric Medicine 5294999744 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01071052INMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adams County Memorial Hospital CurrentSince Aug 15, 2019 Accepting new patients
Adams County Memorial Hospital CurrentSince Aug 15, 2019 Accepting new patients

Locations

1521 W Main St
Ste 1
Berne, IN 46711
Phone (260) 589-2312

1100 Mercer Ave
Decatur, IN 46733

Interoperability endpoints

  • Direct secure messaging: awill11642@direct.parkviewexchange.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1932363587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 W MAIN ST STE 1",
            "city": "BERNE",
            "state": "IN",
            "postal_code": "467111797",
            "telephone_number": "260-589-2312",
            "fax_number": "260-589-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 W MAIN ST STE 1",
            "city": "BERNE",
            "state": "IN",
            "postal_code": "467111797",
            "telephone_number": "260-589-2312",
            "fax_number": "260-589-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILL",
        "first_name": "ADAM",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01071052",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01071052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201037140",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berne, IN

Sources for this page

Verify at the official NPI Registry.