Kathleen Lynn Bemenderfer, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Indianapolis, IN
NPI 1073595013 · NPPES record last updated May 9, 2023
Key facts
- NPI
- 1073595013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 01036273A (IN)
- Practice address
- 7700 Sargent Rd
Indianapolis, IN 46256-1833 - Phone
- (000) 000-0000
- NPI assigned
- Nov 16, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070426000496 | IN | Practitioner - Obstetrics/Gynecology | 5991801656 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01036273A | IN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Obstetrics & Gynecology | Current |
Accepting new patients |
| Community Physicians of Indiana Inc | Current |
Accepting new patients | |
| Obstetrics & Gynecology of Indiana, LLC | Obstetrics & Gynecology | Past | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
8040 Clearvista Pkwy
Ste 490
Indianapolis, IN 46256
Phone (317) 577-7444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 01036273A | IN | Yes |
Addresses
Primary practice location
7700 Sargent Rd
Indianapolis, IN 46256-1833
Mailing address
7700 Sargent Rd
Indianapolis, IN 46256-1833
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100131990 | Medicaid | IN | |
| P01157028 | Other | IN | MEDICARE RAILROAD |
| 000000647923 | Other | IN | ANTHEM |
Other names
- Kathleen Listenberger
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All providers in Indianapolis, IN · Obstetrics & Gynecology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.