Eagle Creek Dermatology

Primary specialty

Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X

License

01024873 Issued in IN

Legal business name

EAGLE CREEK DERMATOLOGY

Practice address

6820 Parkdale PL
Suite 211
Indianapolis, IN 46254-6600

Phone

(317) 329-7050

Fax

(317) 328-6809

NPI assigned

Sep 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ingrida Iveta Ozols, MDNPI 1710068796

Title

Partner

Phone

(317) 329-7050

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ingrida Iveta Ozols, MD

  • Dermatopathology Physician
  • Indianapolis, IN
  • NPI 1710068796

  Clinical & Laboratory Dermatological Immunology

  Medicare reassignment Care Compare group NPD Authorized official
• Nikolajs Perdue, M.D.

  • Dermatology Physician
  • Indianapolis, IN
  • NPI 1639580152
  Medicare reassignment Care Compare group NPD
• Wendy Meade Wilson, MD

  • Clinical & Laboratory Dermatological Immunology Physician
  • Indianapolis, IN
  • NPI 1427145986
  Medicare reassignment Care Compare group NPD
• Mary Coffey Greist, MD

  • Dermatopathology Physician
  • Indianapolis, IN
  • NPI 1306933858

  Clinical & Laboratory Dermatological Immunology

  NPD

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378857600000",
    "number": "1053561928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 PARKDALE PL",
            "address_2": "SUITE 211",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462546600",
            "telephone_number": "317-329-7050",
            "fax_number": "317-328-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 PARKDALE PL",
            "address_2": "SUITE 211",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462546600",
            "telephone_number": "317-329-7050",
            "fax_number": "317-328-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE CREEK DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2013-09-11",
        "status": "A",
        "authorized_official_last_name": "OZOLS",
        "authorized_official_first_name": "INGRIDA",
        "authorized_official_middle_name": "IVETA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "317-329-7050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01027554",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "IN",
            "license": "01024873",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "IN",
            "license": "01057248",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Eads, DNP, RN, ACNS-BC
• Robyn Eads
• Eagle Creek Chiropractic, PC
• Eagle Creek Counseling Services, Inc.
• Eagle Creek Dentistry, LLC
• Eagle Creek Internal Medicine PC
• Eagle Creek Obstetrics & Gynecology, PC
• Eagle Creek Urgent Care LLC
• Eagle Highland Pharmacy Inc
• Eagle Highlands Surgery Center LLC

• Dermatology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (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.