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INTEGRATED BODY AND MEDICINE PC NPI 1407404569


NPI Information

NPI: 1407404569
Provider Name: INTEGRATED BODY AND MEDICINE, PC

Other Name: KENNEDY AVE CHIROPRACTIC

Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 15D2213427

Address:
8145 KENNEDY AVE
HIGHLAND, IN
ZIP 46322
Phone: (219) 803-6630
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INTEGRATED BODY AND MEDICINE, PC is a general practice in Highland, IN. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee INTEGRATED BODY AND MEDICINE, PC NPI is 1407404569. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Kennedy Ave Chiropractic.

The provider's business location address is:

8145 KENNEDY AVE
HIGHLAND, IN
ZIP 46322-128
Phone: (219) 803-6630
Fax: (219) 937-7237

The provider's authorized official is Ahmad Sprouse .
The authorized official title is Owner and has the following contact phone number (219) 803-6630.

The CLIA number assigned to this NPI record is 15D2213427 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2019 and was last updated on 3/1/2022.


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
1208D00000XGeneral PracticeYes

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.