Individual provider Active NPI

Craig M. Novy, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Indianapolis, IN
National Provider Identifier
1023095395
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01059387A Issued in IN
Practice address
2560 N. Shadeland Ave.
Suite a
Indianapolis, IN 46219-1706
Phone
(317) 275-8072
Fax
(317) 275-8018
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01059387A IN Primary

Addresses

Primary practice location

2560 N. Shadeland Ave.
Suite a
Indianapolis, IN 46219-1706

Mailing address

14275 Midway Rd
Sutie 400
Addison, TX 75001-3614
Phone (214) 932-8029

Other identifiers 1

IdentifierTypeStateIssuer
000000339129OtherINANTHEM

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01059387AINMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Indianapolis PC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Major Hospital Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1023095395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUTIE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "214-932-8029",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 N. SHADELAND AVE.",
            "address_2": "SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462191706",
            "telephone_number": "317-275-8072",
            "fax_number": "317-275-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVY",
        "first_name": "CRAIG",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01059387A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000339129",
            "state": "IN"
        }
    ],
    "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 1, 2015; 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.