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EVANSVILLE PRIMARY CARE LLC NPI 1629027800


NPI Information

NPI: 1629027800
Provider Name: EVANSVILLE PRIMARY CARE LLC

Doing Business As: EVANSVILLE PRIMARY CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
4933 E PLAZA EAST BLVD
EVANSVILLE, IN
ZIP 47715
Phone: (812) 479-6907
Get Directions

EVANSVILLE PRIMARY CARE LLC is a family medicine in Evansville, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EVANSVILLE PRIMARY CARE LLC NPI is 1629027800. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Evansville Primary Care.

The provider's business location address is:

4933 E PLAZA EAST BLVD
EVANSVILLE, IN
ZIP 47715-813
Phone: (812) 479-6907
Fax: (812) 479-6967

The provider's authorized official is Kaylynn Cantacessi .
The authorized official title is Manager and has the following contact phone number (812) 479-6907.

The enumeration date for this NPI number is 5/8/2006 and was last updated on 8/1/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNo
2363L00000XNurse PractitionerNo
3207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200321590MEDICAIDINDIANA
21912987363MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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