Provider Demographics
NPI:1912183492
Name:HEALTH 1ST OF ANDERSON
Entity Type:Organization
Organization Name:HEALTH 1ST OF ANDERSON
Other - Org Name:HEALTH 1ST PHYSICAL REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-643-8781
Mailing Address - Street 1:2976 N SCATTERFIELD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-1585
Mailing Address - Country:US
Mailing Address - Phone:765-643-8781
Mailing Address - Fax:
Practice Address - Street 1:2976 N SCATTERFIELD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-1585
Practice Address - Country:US
Practice Address - Phone:765-643-8781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001691A111N00000X
IN01047723A207R00000X
IN05008202A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200108320Medicaid
1275552481OtherNPI#
1184794901OtherNPI#
1184794901OtherNPI#