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Organization
CENTRAL INDIANA PHYSICIAN ALLIANCE, LLC
Active
Organization
CENTRAL INDIANA PHYSICIAN ALLIANCE, LLC
Active
Parent organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC.
Other names
IU Health Tipton Physicians
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC.
Authorized official
KIMBERLEE SHERBROOKE (COO)
(317) 278-3505
Entity
Organization
Contact information
Practice address
1000 S MAIN ST, TIPTON, IN 46072-9753
(765) 675-1745
(765) 675-8257
Mailing address
340 W 10TH ST, FS 5100, INDIANAPOLIS, IN 46202-3082
(317) 278-3505
(317) 278-3502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000570072
ANTHEM
IN
05
—
200900360
—
IN
Enumeration date
02/07/2008
Last updated
08/19/2014
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