CHARLESTOWN PRIMARY CARE LLC NPI 1114108164

NPI Information

NPI: 1114108164
Provider Name: CHARLESTOWN PRIMARY CARE LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
3901 COUNTY ROAD 160
CHARLESTOWN, IN
ZIP 47111
Phone: (812) 406-6897
Get Directions

CHARLESTOWN PRIMARY CARE LLC is a family medicine in Charlestown, 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. CHARLESTOWN PRIMARY CARE LLC NPI is 1114108164. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3901 COUNTY ROAD 160
CHARLESTOWN, IN
ZIP 47111-181
Phone: (812) 406-6897
Fax: (812) 256-3577

The provider's authorized official is Willam E Hoke .
The authorized official title is Member and has the following contact phone number (812) 256-1106.

The enumeration date for this NPI number is 11/19/2007 and was last updated on 4/18/2019.

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
1	363L00000X	Nurse Practitioner		71003560A	INDIANA	No
2	363LF0000X	Nurse Practitioner	Family	71002399A	INDIANA	No
3	207Q00000X	Family Medicine		01061465A	INDIANA	Yes

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
1	000000549269	OTHER	INDIANA	ANTHEM GROUP NUMBER
2	20089454A	MEDICAID	INDIANA

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: 11/14/2023

NPI Synchronization or Removal

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