Healthcare Provider Details

I. General information

NPI: 1639120918
Provider Name (Legal Business Name): UNITY HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 S CREASY LN SUITE 120
LAFAYETTE IN
47905-7438
US

IV. Provider business mailing address

PO BOX 4699
LAFAYETTE IN
47903-4699
US

V. Phone/Fax

Practice location:
  • Phone: 765-447-4165
  • Fax: 765-447-4168
Mailing address:
  • Phone: 765-446-5417
  • Fax: 765-446-5317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number207X00000X
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number207XS0117X
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number207XX0005X
License Number StateIN

VIII. Authorized Official

Name: HEATHER DAWSON
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 765-446-5417