NPIMap

Organization Active NPI

Podiatry Associates of Indiana PC

  • Foot & Ankle Surgery Podiatrist
  • Indianapolis, IN
National Provider Identifier
1073606935
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PODIATRY ASSOCIATES OF INDIANA PC
Practice address
5471 Georgetown Rd Ste C
Indianapolis, IN 46254-5794
Phone
(317) 297-0661
Fax
(317) 328-6338
NPI assigned
Oct 2, 2006
Last updated
Feb 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Sandra C Raynor, DPM
Title
Owner
Phone
(317) 297-0661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

5471 Georgetown Rd Ste C
Indianapolis, IN 46254-5794

Mailing address

5471 Georgetown Rd Ste C
Indianapolis, IN 46254-5794
Phone (317) 297-0661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040901000419 IN Part B Supplier - Clinic/Group Practice 0143295253 Receives reassigned benefits from 17 practitioners
Practice locations: Indianapolis, IN; Plainfield, IN; Noblesville, IN; Carmel, IN; Avon, IN
O20100930065151 IN DME Supplier - Physician - Podiatry 0143295253 Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

1115 Ronald Reagan Pkwy
Ste 336
Avon, IN 46123
Phone (317) 217-2022

12425 Old Meridian St
Ste A2
Carmel, IN 46032
Phone (317) 564-0958

201 Pennsylvania Pkwy
Ste 305
Carmel, IN 46280
Phone (317) 621-3338

13121 Olio Rd
Ste 100B
Fishers, IN 46037
Phone (317) 621-3338

1633 N Capitol Ave
Ste 536
Indianapolis, IN 46202
Phone (317) 924-4797

1801 Senate Blvd
Ste 610
Indianapolis, IN 46202
Phone (317) 924-4797

5471 Georgetown Rd
Ste C
Indianapolis, IN 46254
Phone (317) 297-0661

7950 N Shadeland Ave
Ste 100
Indianapolis, IN 46250
Phone (317) 588-7130

8101 Clearvista Pkwy
Ste 250
Indianapolis, IN 46256
Phone (317) 621-3338

8615 US 31
#Sa
Indianapolis, IN 46227
Phone (317) 888-0596

9670 E Washington St
Ste 215
Indianapolis, IN 46229
Phone (317) 452-8717

13436 Tegler Dr
Ste 100
Noblesville, IN 46060
Phone (317) 537-8200

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1073606935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 GEORGETOWN RD STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545794",
            "telephone_number": "317-297-0661",
            "fax_number": "317-328-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 GEORGETOWN RD STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545794",
            "telephone_number": "317-297-0661",
            "fax_number": "317-328-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY ASSOCIATES OF INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "RAYNOR",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-297-0661",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.