Madison Direct Health – Primary Care Clinic/Center

Key facts

NPI: 1013513282
Entity type: Organization (NPI type 2)
Primary specialty: Primary Care Clinic/Center 261QP2300X
Legal business name: MADISON DIRECT HEALTH
Practice address: 110 Holt Dr
Madison, IN 47250-3873
Phone: (812) 265-2500
NPI assigned: Dec 11, 2020
Organization subpart: No

Authorized official

Name: Brandy Smith, APRN
Title: Owner/Manager
Phone: (812) 265-2500

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
15D2196178	Madison Direct Health 110 Holt Drive, Madison, IN 47250	Certificate of waiver	Oct 14, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IN

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20201230000518	IN	Part B Supplier - Clinic/Group Practice	8628481132	Practice locations: Madison, IN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Primary Care Clinic/Center	261QP2300X			Yes

Addresses

Primary practice location

110 Holt Dr
Madison, IN 47250-3873

Mailing address

PO Box 1414
Madison, IN 47250-1414
Phone (812) 265-2500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 27, 2023.

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1013513282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1414",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472501414",
            "telephone_number": "812-265-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOLT DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503873",
            "telephone_number": "812-265-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON DIRECT HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "812-265-2500",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, IN

All providers in Madison, IN · Primary Care Clinic/Center in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.