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BLUE ELK FAMILY CLINIC LLC NPI 1104499649


NPI Information

NPI: 1104499649
Provider Name: BLUE ELK FAMILY CLINIC LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 15D2182120

Address:
50 E WILLOW ST STE C
NASHVILLE, IN
ZIP 47448
Phone: (812) 200-8265
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BLUE ELK FAMILY CLINIC LLC is a family medicine in Nashville, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BLUE ELK FAMILY CLINIC LLC NPI is 1104499649. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

50 E WILLOW ST STE C
NASHVILLE, IN
ZIP 47448
Phone: (812) 200-8265
Fax: (833) 972-1963

The provider's authorized official is Lawrence David Sanchez .
The authorized official title is Owner/physician and has the following contact phone number (812) 200-8265.

The CLIA number assigned to this NPI record is 15D2182120 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2021 and was last updated on 7/22/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1300046197MEDICAIDINDIANA
2000001485581OTHERANTHEM PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.