Southern Indiana Family Practice Center PC
NPI 1770626152ActiveOrganization· Preferred Provider Organization· Bloomington, IN
Preferred Provider Organization in Bloomington, Indiana, registered in NPPES in February 2007. The authorized official on file is Karen L. Reid-Renner, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1770626152 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 15, 2007 |
| Last updated in NPPES | Nov 20, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Preferred Provider Organization Primary | 305R00000X | 01055670A | IN |
| Nurse Practitioner | 363L00000X | 71002130A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|