Organization
ST. JOSEPH PRIMARY CARE, LLC
Active
Other names
Ascension St. Vincent Kokomo Services
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MORRIS (CFO (AMG))
(317) 338-6234
Entity
Organization
Contact information
Practice address
1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
(765) 456-5433
Mailing address
3109 W SYCAMORE ST, KOKOMO, IN 46901-4181
(765) 457-8381
(765) 457-4443
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
742949291
IN
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0008X
Hepatology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183506
BLUE CROSS BLUE SHIELD
IN
05
—
200312000
—
IN
Enumeration date
03/12/2007
Last updated
02/20/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us