EASTSIDE FAMILY MEDICINE
NPI 1609940105
Family Medicine in Crawfordsville, IN

NPI Status: Active since November 17, 2006

Contact Information

2056 LEBANON RD
CRAWFORDSVILLE, IN
ZIP 47933
Phone: (765) 361-9923

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  • Organization
  • Family Medicine
  • CLIA Number: 15D0966903
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-13-2026

About EASTSIDE FAMILY MEDICINE

This page provides the complete NPI Profile along with additional information for Eastside Family Medicine, a primary care provider established in Crawfordsville, Indiana operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1609940105 assigned on November 2006. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Eastside Family Medicine. The authorized official of this NPI record is Jim Siemers (Executive Director)

NPI
1609940105
Provider Legal Name
ST CLARE HEALTH NETWORK
Other Organization Name
EASTSIDE FAMILY MEDICINE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2056 LEBANON RD CRAWFORDSVILLE, IN 47933
Location Phone
(765) 361-9923
Mailing Address
1710 LAFAYETTE RD CRAWFORDSVILLE, IN 47933
Mailing Phone
(765) 362-2800
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
11-17-2006
Last Update Date
07-24-2008
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A primary care provider (PCP) like Eastside Family Medicine sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Group Taxonomy 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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JIM SIEMERS

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(765) 362-2800

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
150970MEDICARE PIN (08)IN 
CG2471MEDICARE PIN (08)IN 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
15D0966903
Facility Type
Physician Office
Certificate Effective Date
September 14, 2024
Certificate Expiration Date
September 13, 2026
Laboratory Director
BARRY A. MATHISON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Eastside Family Medicine to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for EASTSIDE FAMILY MEDICINE

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1609940105
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2609184010
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 1 + 8 + 4 + 0 + 1 + 0 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1609940105 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

STEVEN TRIMBLE P.A. - C.

Physician Assistant

2056 LEBANON RD
CRAWFORDSVILLE, IN
ZIP 47933

(765) 361-9930

AIMEE ELIZABETH BARNETT N.P.

Nurse Practitioner

(Family)

2056 LEBANON RD
CRAWFORDSVILLE, IN
ZIP 47933

(765) 361-9930

BARRY A MATHISON M.D.

Family Medicine

2056 LEBANON RD
CRAWFORDSVILLE, IN
ZIP 47933

(765) 361-9930

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609940105, enumerated as an "organization" on November 17, 2006.

The provider is located at 2056 LEBANON RD CRAWFORDSVILLE, IN 47933 and the phone number is (765) 361-9923.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.