Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
SOUTHERN INDIANA FAMILY PRACTICE CENTER PC
Active
Organization
SOUTHERN INDIANA FAMILY PRACTICE CENTER PC
Active
Other names
Southern Indiana Family Practice Center
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN L. REID-RENNER MD (OWNER)
(812) 339-6744
Entity
Organization
Contact information
Practice address
3209 W FULLERTON PIKE, STE A, BLOOMINGTON, IN 47403-4060
(812) 339-6744
(812) 671-9113
Mailing address
3209 W FULLERTON PIKE, STE A, BLOOMINGTON, IN 47403-4060
(812) 339-6744
(812) 671-9113
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
01055670A
IN
363L00000X
Nurse Practitioner
71002130A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200367600A
—
IN
Enumeration date
02/15/2007
Last updated
11/20/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up