MSO CLINICS, INC. (NPI# 1619396728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619396728 |
| Entity Type | Organization |
| Organization Name | MSO CLINICS, INC. |
| Other Organization Name | LAKESIDE FAMILY MEDICAL |
| Practice Address |
2186 N Hospital Blvd #2 Sullivan IN 47882-7523 |
| Mailing Address |
Po Box 230 Sullivan IN 47882-0230 |
| Practice Telephone | 8122683318 |
| Practice Fax Number | 8122684017 |
| Mailing Telephone | 8122683318 |
| Mailing Fax Number | 8122684017 |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2015-03-05 |
| Authorized Official Name | MRS. MICHELLE FRANKLIN (CEO) |
| Authorized Official Telephone | 8122684311 |
| Authorized Official Credential | MSN |
| Is Organization Subpart | Y |
| Parent Organization Name | SULLIVAN COUNTY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201246990B | 05 | |
| IN | MEDICARE PART B | IN2042 | 01 |
| Other Name | Type Code |
|---|---|
| Lakeside Family Medical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881071108 | Mso Clinics, Inc. | Clinic/Center | 1602 N Upper 11 Street, Vincennes, IN 47591-4820 | 2015-05-06 |
| 1699194704 | Mso Clinics, Inc. | Clinic/Center | 8685 Old Highway 41 South, Carlisle, IN 47838-8234 | 2014-04-16 |
| 1720524945 | Mso Clinics, Inc. | Clinic/Center | 8685 Old Highway 41 South, Carlisle, IN 47838 | 2017-01-11 |
| 1700256948 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2015-09-30 |
| 1811317977 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2014-04-16 |
| 1154741296 | Mso Clinics, Inc. | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-04-16 |
| 1063831527 | Mso Clinics, Inc. | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-04-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MSO CLINICS, INC. | 2200 N Section St, Po Box 10, Sullivan, IN 47882 |
| Street Address |
2186 N HOSPITAL BLVD #2 |
| City | SULLIVAN |
| State | IN |
| Zip Code | 47882-7523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659718336 | Neil Lynn Smith | Dentist | 118 S. Court St., Sullivan, IN 47882 | 2013-06-04 |
| 1184888000 | Mary Sherman Hospital | Hospice Care, Community Based | 817 North Section Street, Suite A, Sullivan, IN 47882 | 2008-07-10 |
| 1003838194 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 505 West Wolfe Street, Sullivan, IN 47882 | 2006-07-24 |
| 1255580593 | Daniel Choyce Callahan | Psychiatry & Neurology | 2204 N Section St, Sullivan, IN 47882 | 2008-09-11 |
| 1851394175 | Van Evanoff Jr. | Pain Medicine | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2005-05-31 |
| 1982780748 | Associated Physicians & Surgeons Clinic, LLC | Obstetrics & Gynecology | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2006-10-27 |
| 1871996199 | Sullivan Family Dentistry, LLC | Dentist | 2186 N Hospital Blvd., Suite 1, Sullivan, IN 47882-0468 | 2014-10-01 |
| 1487828455 | Kortni Reann Martindale | Speech-Language Pathologist | 368 W Indiana Ave, Sullivan, IN 47882-1117 | 2008-04-21 |
| 1831280585 | Southwest School Corporation | Local Education Agency (LEA) | 110 N Main St, Sullivan, IN 47882-1225 | 2006-09-27 |
| 1780717637 | Brian K Grindstaff | Chiropractor | 210 N Section St Unit C, Sullivan, IN 47882-1237 | 2007-03-13 |
| Find all providers in zip 47882 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700256948 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2015-09-30 |
| 1154741296 | Mso Clinics, Inc. | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-04-16 |
| 1467884643 | Sullivan County Community Hospital | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2013-07-30 |
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| 1982255667 | Careatc | Clinic/Center | 59427 County Road 13, Elkhart, IN 46517-3503 | 2019-09-24 |
| 1134777824 | Activate Healthcare - Mcoe Clinic | Clinic/Center | 6920 Parkdale Pl Ste 100, Indianapolis, IN 46254-5604 | 2019-08-27 |
| 1457906141 | With Dignity Too LLC | Clinic/Center | 1958 West Boulivard, Kokomo, IN 46902 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
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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.