Provider Demographics
NPI:1841245636
Name:ORTHOPAEDIC CARE CENTER UNDER JOHNSON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ORTHOPAEDIC CARE CENTER UNDER JOHNSON MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CPPM
Authorized Official - Phone:317-736-7603
Mailing Address - Street 1:PO BOX 800
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-0800
Mailing Address - Country:US
Mailing Address - Phone:317-346-2750
Mailing Address - Fax:317-346-2712
Practice Address - Street 1:1125 W JEFFERSON ST STE 200
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131
Practice Address - Country:US
Practice Address - Phone:317-346-3100
Practice Address - Fax:317-346-3660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200373250AMedicaid
IN000000221767OtherANTHEM
IN1558359646OtherINDIVIDUAL NPI
IN1558359570OtherINDIVIDUAL NPI
IN000000222821OtherANTHEM
IN191310Medicare PIN
IN1558359646OtherINDIVIDUAL NPI