NPIMap

Organization Active NPI

Southern Indiana Imaging Consultants P C

  • Diagnostic Radiology Physician
  • Evansville, IN
National Provider Identifier
1972598886
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SOUTHERN INDIANA IMAGING CONSULTANTS P C
Practice address
3700 Washington Ave
Evansville, IN 47750-0001
Phone
(812) 485-4415
Fax
(812) 471-6650
NPI assigned
Sep 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Thomas E Schultheis, MD
Title
President
Phone
(812) 471-1591

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

3700 Washington Ave
Evansville, IN 47750-0001

Mailing address

PO Box 138
Evansville, IN 47701-0138
Phone (812) 471-1591

Other identifiers 1

IdentifierTypeStateIssuer
200175370MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI, MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040720001194 IN Part B Supplier - Clinic/Group Practice 2062492291 Receives reassigned benefits from 16 practitioners
Practice locations: Evansville, IN; Newburgh, IN; Fishers, IN; Boonville, IN
O20230622000970 MI Part B Supplier - Clinic/Group Practice 2062492291 Receives reassigned benefits from 1 practitioner
Practice locations: Traverse City, MI
O20230901000349 MN Part B Supplier - Clinic/Group Practice 2062492291 Practice locations: Rochester, MN

National Provider Directory

National Provider Directory

Locations

14020 Old State Rd
Evansville, IN 47725
Phone (812) 469-4700

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1972598886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 138",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477010138",
            "telephone_number": "812-471-1591",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477500001",
            "telephone_number": "812-485-4415",
            "fax_number": "812-471-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INDIANA IMAGING CONSULTANTS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "SCHULTHEIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-471-1591",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200175370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.