Provider Demographics
NPI:1487056388
Name:AMSURG INDIANAPOLIS ANESTHESIA LLC
Entity type:Organization
Organization Name:AMSURG INDIANAPOLIS ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR OF RCM TRANSFORMATION
Authorized Official - Prefix:MISS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHENDORFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-240-3795
Mailing Address - Street 1:1A BURTON HILLS BLVD
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6187
Mailing Address - Country:US
Mailing Address - Phone:615-240-3809
Mailing Address - Fax:615-234-1809
Practice Address - Street 1:8424 NABB ROAD
Practice Address - Street 2:SUITE 3-G
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1975
Practice Address - Country:US
Practice Address - Phone:317-871-7308
Practice Address - Fax:317-871-7314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty