SOUTHERN INDIANA FAMILY PRACTICE CENTER
NPI 1770626152
Preferred Provider Organization in Bloomington, IN
NPI Status: Active since February 15, 2007
Contact Information
3209 W FULLERTON PIKE
STE A
BLOOMINGTON, IN
ZIP 47403
Phone: (812) 339-6744
Fax: (812) 671-9113
- Organization
- Preferred Provider Organization
- Accepts Insurance
- CLIA Number: 15D0998905
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-09-2028
About SOUTHERN INDIANA FAMILY PRACTICE CENTER
This page provides the complete NPI Profile along with additional information for Southern Indiana Family Practice Center, a provider established in Bloomington, Indiana operating as a Preferred Provider Organization. The healthcare provider is registered in the NPI registry with number 1770626152 assigned on February 2007. The practitioner's primary taxonomy code is 305R00000X with license number 01055670A (IN). The provider is registered as an organization and their NPI record was last updated 11 years ago. Southern Indiana Family Practice Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Southern Indiana Family Practice Center. The authorized official of this NPI record is Karen L. Reid-renner Md (Owner)
- NPI
- 1770626152
- Provider Legal Name
- SOUTHERN INDIANA FAMILY PRACTICE CENTER PC
- Other Organization Name
- SOUTHERN INDIANA FAMILY PRACTICE CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3209 W FULLERTON PIKE STE A BLOOMINGTON, IN 47403
- Location Phone
- (812) 339-6744
- Location Fax
- (812) 671-9113
- Mailing Address
- 3209 W FULLERTON PIKE STE A BLOOMINGTON, IN 47403
- Mailing Phone
- (812) 339-6744
- Mailing Fax
- (812) 671-9113
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-15-2007
- Last Update Date
- 11-20-2015
- Code Navigator
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
Preferred Provider Organization
- Taxonomy Code
- 305R00000X
- Type
- Managed Care Organizations
- License No.
- 01055670A
- License State
- IN
- Taxonomy Description
- A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 71002130A (IN) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Bronze 7500 $25 Generic Drugs - HMO
- Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Gold 2000 $15 Generic Drugs - HMO
- Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
- Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
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.
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 |
|---|---|---|---|
| G99934 | MEDICARE UPIN (02) | IN | |
| 188690 | MEDICARE ID-TYPE UNSPECIFIED (04) | IN | |
| 200367600A | MEDICAID (05) | 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
- 15D0998905
- Facility Type
- Physician Office
- Certificate Effective Date
- February 10, 2026
- Certificate Expiration Date
- February 09, 2028
- Laboratory Director
- KAREN L. REID-RENNER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southern Indiana Family Practice Center 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1770626152, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770626152, enumerated as an "organization" on February 15, 2007.
The provider is located at 3209 W FULLERTON PIKE STE A BLOOMINGTON, IN 47403 and the phone number is (812) 339-6744.
Preferred Provider Organization with taxonomy code 305R00000X.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
