Active NPI
Keoambi Lumpkin
- In Home Supportive Care Agency
- Indianapolis, IN
National Provider Identifier
1003612797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 2226 Bernie Dr
Indianapolis, IN 46229 - Phone
- (317) 622-8422
- NPI assigned
- Feb 22, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28187284A | IN | |
| Attendant Care Provider | 3747A0650X | |||
| Personal Care Attendant | 3747P1801X | |||
| Homemaker | 376J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
2226 Bernie Dr
Indianapolis, IN 46229
Mailing address
2226 Bernie Dr
Indianapolis, IN 46229
Phone (317) 622-8422
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28187284A | IN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740182400000",
"number": "1003612797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2226 BERNIE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46229",
"telephone_number": "317-622-8422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2226 BERNIE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46229",
"telephone_number": "317-622-8422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUMPKIN",
"first_name": "KEOAMBI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-22",
"last_updated": "2025-02-22",
"certification_date": "2025-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28187284A",
"primary": false
},
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"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 Feb 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.