ST JOSEPH PRIMARY LLC NPI 1477590164

NPI Information

  • NPI: 1477590164
  • Provider Name: ST JOSEPH PRIMARY LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: ST JOSEPH PHYSICIANS SOUTHWAY
  • Address: 188 E SOUTHWAY BLVD
    KOKOMO, IN
    ZIP 46902
  • Phone: (765) 453-9000

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NPI Details

ST JOSEPH PRIMARY LLC is a family medicine in Kokomo, 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. ST JOSEPH PRIMARY LLC NPI is 1477590164. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As St Joseph Physicians Southway.

The provider's business location address is:

188 E SOUTHWAY BLVD
KOKOMO, IN
ZIP 46902-650
Phone: (765) 453-9000
Fax: (765) 457-4443

The provider's authorized official is Andrew Kellar .
The authorized official title is Regional Practice Administrator and has the following contact phone number (765) 457-8381.

The enumeration date for this NPI number is 6/1/2006 and was last updated on 11/16/2007.

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
1207Q00000XFamily MedicineINDIANAYes

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
1170710MEDICARE PININDIANA
2000000183506OTHERINDIANABLUE CROSS BLUE SHIELD

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: 11/21/2025

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