INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC (NPI# 1003074972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003074972 |
| Entity Type | Organization |
| Organization Name | INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC |
| Other Organization Name | GOSPORT FAMILY PRACTICE |
| Practice Address |
7 E Main St Gosport IN 47433-7034 |
| Mailing Address |
Po Box 1329 Bloomington IN 47402-1329 |
| Practice Telephone | 8128794222 |
| Practice Fax Number | 8128794834 |
| Mailing Telephone | 8128794222 |
| Mailing Fax Number | 8128794834 |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2011-09-13 |
| Authorized Official Name | MR. MARLON B FISHEL (ADMINISTRATION, IU HEALTH SIP) |
| Authorized Official Telephone | 8123535866 |
| Is Organization Subpart | Y |
| Parent Organization Name | INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200874400A | 05 | |
| IN | RAILROAD MEDICARE | CI4187 | 01 |
| Other Name | Type Code |
|---|---|
| Gosport Family Practice | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578082350 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 2605 E Creeks Edge Dr, Bloomington, IN 47401-8368 | 2017-09-13 |
| 1033537030 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 9 N Crane Ave, Spencer, IN 47460-1507 | 2014-04-07 |
| 1740608926 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 2209 John R Wooden Dr, Martinsville, IN 46151-1840 | 2014-04-03 |
| 1295153468 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 642 W Hospital Rd, Paoli, IN 47454-9672 | 2014-04-03 |
| 1427476696 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2014-04-03 |
| 1225456668 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 2900 16th St, Bedford, IN 47421-3510 | 2014-04-02 |
| 1366600231 | Indiana University Health Southern Indiana Physicians, Inc | Clinic/Center | 9 N Crane Ave, Spencer, IN 47460-1507 | 2008-05-28 |
| 1619199155 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2007-05-03 |
| 1013953983 | Indiana University Health Southern Indiana Physicians, Inc | Emergency Medicine | 1302 S Rogers St, Bloomington, IN 47403-4752 | 2006-06-21 |
| Street Address |
7 E MAIN ST |
| City | GOSPORT |
| State | IN |
| Zip Code | 47433-7034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851379382 | Peggy Ann Walters | Nurse Practitioner | 7 E Main St, Gosport, IN 47433 | 2006-01-05 |
| 1407207079 | Sarah Truax | Nurse Practitioner | 7 E Main St, Gosport, IN 47433-7034 | 2016-06-24 |
| 1245586718 | Sonya Kay Ruedlinger | Nurse Practitioner | 7 E Main St, Gosport, IN 47433-7034 | 2012-08-02 |
| 1619245909 | Cynthia L Colglazier | Nurse Practitioner | 7 E Main St, Gosport, IN 47433-7034 | 2011-12-01 |
| 1508062100 | Meredith Lulich | Internal Medicine | 7 E Main St, Gosport, IN 47433-7034 | 2007-06-21 |
| 1811949175 | John Stearley | Family Medicine | 7 E Main St, Gosport, IN 47433-7034 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750585766 | Gosport Care, Inc. | Nursing Facility/Intermediate Care Facility | 27 S. 7th St., Gosport, IN 47433-0099 | 2007-06-13 |
| 1033216411 | Barbara A. Lamere-heck | Dentist | 10 East Main Street, Gosport, IN 47433-0189 | 2006-09-20 |
| 1194801233 | Julie D. Surber | Dental Hygienist | 10 E. Main St., Gosport, IN 47433-0189 | 2006-10-31 |
| 1659902013 | Southern Indiana Mobile Therapy Services | Physical Therapist | 5587 Limestone Creek Rd, Gosport, IN 47433-7950 | 2020-02-03 |
| 1033230057 | Annette Moore Settle | Physical Therapist | 4252 Whiteys Way, Gosport, IN 47433-8229 | 2007-04-03 |
| 1447883517 | Casey Jo Cummins | Registered Nurse | 5621 S Darrell Ln, Gosport, IN 47433-8977 | 2020-02-18 |
| 1396126447 | Paula Dorland Jarrard | Occupational Therapist | 1198 W Fry Rd, Gosport, IN 47433-9529 | 2015-06-15 |
| 1447422191 | Terry R. Eads | Social Worker | 1351 W Burma Rd, Gosport, Gosport, IN 47433-9573 | 2008-04-01 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679182190 | Indiana University Health Paoli Inc | Clinic/Center | 560 W. Longest Street, Paoli, IN 47454-9670 | 2020-07-30 |
| 1255965083 | True Healthcare Partner LLC | Clinic/Center | 104 North Webster Street, Saint Paul, IN 47272-9435 | 2020-03-02 |
| 1659935781 | Rush Memorial Hospital | Clinic/Center | 201 Conrad Harcourt Way Ste A, Rushville, IN 46173-1157 | 2019-04-24 |
| 1174186894 | Woodlawn Hospital | Clinic/Center | 100 E Dunn St, Fulton, IN 46931 | 2019-04-18 |
| 1710540695 | Woodlawn Hospital | Clinic/Center | 105 N Sr 14, Akron, IN 46910 | 2019-04-17 |
| 1174091771 | Baptist Health Medical Group Inc | Clinic/Center | 313 Federal Dr Nw Ste 130, Corydon, IN 47112-3099 | 2018-11-13 |
| 1457860173 | Major Hospital | Clinic/Center | 2451 Intelliplex Dr Ste 230, Shelbyville, IN 46176-8581 | 2017-09-26 |
| 1699194704 | Mso Clinics, Inc. | Clinic/Center | 8685 Old Highway 41 South, Carlisle, IN 47838-8234 | 2014-04-16 |
| 1538417860 | Reid Physician Associates, Inc | Clinic/Center | 1250 Chester Blvd Ste 2, Richmond, IN 47374-1944 | 2012-08-16 |
| 1023340965 | Daviess County Hospital | Clinic/Center | 1805 S State Road 57, Washington, IN 47501-4326 | 2010-02-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.