NPIMap

Organization Active NPI

University Dermatology, Inc.

  • Dermatology Physician
  • Indianapolis, IN
National Provider Identifier
1033159405
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
UNIVERSITY DERMATOLOGY, INC.
Practice address
550 University Blvd
Uh 3240
Indianapolis, IN 46202-5149
Phone
(317) 944-7744
Fax
(317) 944-7051
NPI assigned
Jun 7, 2006
Last updated
Sep 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Authorized official

Name
Chris Goodin
Title
Administrator
Phone
(317) 274-3809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

550 University Blvd
Uh 3240
Indianapolis, IN 46202-5149

Mailing address

545 Barnhill Dr
Eh 139
Indianapolis, IN 46202-5112
Phone (317) 944-7744

Other identifiers 1

IdentifierTypeStateIssuer
200208370MedicaidIN

National Provider Directory

National Provider Directory

Locations

7593 Solutions Ctr
Chicago, IL 60677

10300 N Illinois St
Ste 1500
Carmel, IN 46290
Phone (317) 948-5926

11590 N Meridian St
Ste 450
Carmel, IN 46032
Phone (317) 948-5926

1701 N Senate Ave
Indianapolis, IN 46202
Phone (317) 929-8447

550 University Blvd
#3240
Indianapolis, IN 46202
Phone (317) 274-7740

710 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 274-2524

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1033159405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 BARNHILL DR",
            "address_2": "EH 139",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025112",
            "telephone_number": "317-944-7744",
            "fax_number": "317-944-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "address_2": "UH 3240",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-944-7744",
            "fax_number": "317-944-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "GOODIN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "317-274-3809"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200208370",
            "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 Sep 14, 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.