Active NPI
Anantachote Vimuktanandana, M.D.
- Student in an Organized Health Care Education/Training Program
- Indianapolis, IN
National Provider Identifier
1003074451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 11013134A
- Practice address
- 755 W Walnut St Apt D
Indianapolis, IN 46202-3179 - Phone
- (317) 979-8409
- NPI assigned
- May 31, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 11013134A | IN | Primary |
Addresses
Primary practice location
755 W Walnut St Apt D
Indianapolis, IN 46202-3179
Mailing address
755 W Walnut St Apt D
Indianapolis, IN 46202-3179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11013134A | IN | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212192000000",
"number": "1003074451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 W WALNUT ST APT D",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462023179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 W WALNUT ST APT D",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462023179",
"telephone_number": "317-979-8409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIMUKTANANDANA",
"first_name": "ANANTACHOTE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-31",
"last_updated": "2008-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IN",
"license": "11013134A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.