Individual provider Active NPI

William R Nunery, MD

  • Facial Plastic Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1063410942
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
01026942A Issued in IN
Practice address
201 Pennsylvania Pkwy
Suite 225
Indianapolis, IN 46280-2301
Phone
(317) 573-1000
Fax
(317) 573-0205
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 01026942A IN Primary

Addresses

Primary practice location

201 Pennsylvania Pkwy
Suite 225
Indianapolis, IN 46280-2301

Mailing address

201 Pennsylvania Pkwy
Suite 225
Indianapolis, IN 46280-2301
Phone (317) 573-1000

Other identifiers 1

IdentifierTypeStateIssuer
100351370MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01026942AINMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Eye Care Inc. Past Accepting new patients
Ophthalmic Plastic Surgery Inc 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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1063410942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 225",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802301",
            "telephone_number": "317-573-1000",
            "fax_number": "317-573-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 225",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802301",
            "telephone_number": "317-573-1000",
            "fax_number": "317-573-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNERY",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "IN",
            "license": "01026942A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100351370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.