RECONSTRUCTIVE HAND TO SHOULDER OF INDIANA, LLC NPI 1003000399

Orthopaedic Surgery (Hand Surgery) in Carmel, IN

About RECONSTRUCTIVE HAND TO SHOULDER OF INDIANA, LLC

Reconstructive Hand To Shoulder Of Indiana, Llc is a provider in Carmel, IN. The NPI number assigned to this provider is 1003000399. The practitioner's primary taxonomy code is Orthopaedic Surgery (207XS0106X). The provider is registered as an organization and their NPI record was last updated 4 years ago. Reconstructive Hand To Shoulder Of Indiana, Llc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's former legal business name is Reconstructive Hand Surgeons Of Indiana.

NPI

1003000399

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameRECONSTRUCTIVE HAND TO SHOULDER OF INDIANA, LLC
Provider Location Address13431 OLD MERIDIAN STREET SUITE 225 CARMEL, IN 46032 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address13431 OLD MERIDIAN STREET SUITE 225 CARMEL, IN 46032 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameRECONSTRUCTIVE HAND SURGEONS OF INDIANA Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeFormer Legal Business Name (4)
Enumeration Date08-30-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date05-19-2014 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code207XS0106X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
SpecializationHand Surgery
License StateIN
Taxonomy DescriptionAn orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

Business Address

RECONSTRUCTIVE HAND TO SHOULDER OF INDIANA, LLC
13431 OLD MERIDIAN STREET
SUITE 225
CARMEL, IN
ZIP 46032
Phone: (317) 249-2616
Fax: (317) 249-2618

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Mailing Address

RECONSTRUCTIVE HAND TO SHOULDER OF INDIANA, LLC
13431 OLD MERIDIAN STREET
SUITE 225
CARMEL, IN
ZIP 46032
Phone: (317) 249-2616
Fax: (317) 249-2618

Authorized Official

Authorized Official NameMR. MICHAEL E PANNUNZIO M.D. Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitlePARTNER
Authorized Official Phone(317) 249-2616

193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
01063681AOTHER (01)IN
H21285MEDICARE UPIN (02)IN
H16915MEDICARE UPIN (02)IN
6019520001MEDICARE NSC (07)IN
252680MEDICARE UPIN (02)IN
90579MEDICARE UPIN (02)IN
D94498MEDICARE UPIN (02)IN
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