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FOUNDATIONS FAMILY MEDICINE PC NPI 1720097322


NPI Information

NPI: 1720097322
Provider Name: FOUNDATIONS FAMILY MEDICINE PC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 15D1028713

Address:
25 W MAIN ST
AUSTIN, IN
ZIP 47102
Phone: (812) 794-8100
Get Directions

FOUNDATIONS FAMILY MEDICINE PC is a multi-specialty clinic center in Austin, IN. FOUNDATIONS FAMILY MEDICINE PC NPI is 1720097322. The provider is registered as an organization entity type.

The provider's business location address is:

25 W MAIN ST
AUSTIN, IN
ZIP 47102-303
Phone: (812) 794-8100
Fax: (812) 794-8200

The provider's authorized official is William E Cooke .
The authorized official title is Director/officer and has the following contact phone number (812) 794-8100.

The CLIA number assigned to this NPI record is 15D1028713 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 7/1/2013.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-Specialty01056407AINDIANAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200490500AMEDICAIDINDIANA
2153883MEDICARE OSCAR/CERTIFICATIONINDIANA
3DC0744OTHERINDIANARR MEDICARE
4218850MEDICARE PININDIANA

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: 5/5/2024
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