Derris Ross

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Practice address

3939 N Arlington Ave
Indianapolis, IN 46226-4816

Phone

(463) 222-7550

NPI assigned

Sep 13, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Root Therapy LLC

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1275292864
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1003586934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 E 42ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462265515",
            "telephone_number": "463-222-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 N ARLINGTON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462264816",
            "telephone_number": "463-222-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "DERRIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "roottherapyllc",
            "affiliation": "N",
            "endpointDescription": "addressing the root causes",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3939 N Arlington Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462264816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anthony J Ross, MD
• Ashley Renee Ross, COTA
• Bryan James Ross, M.D
• Christian Thomas Ross, MD
• Darrel Lawrence Ross, MD
• Emma Grace Ross, RD, LD
• John K Ross
• Kylie Marie Ross, CPNP, MSN, RN
• Lillie Nicole Ross, PA-C
• Maria Ross, NP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.