Individual provider Active NPI

Cecelia A Powless, MD

  • Obstetrics & Gynecology Physician
  • Kokomo, IN
National Provider Identifier
1093727620
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01066978A Issued in IN
Practice address
3510 S Lafountain St
Kokomo, IN 46902-3803
Phone
(765) 864-8765
Fax
(765) 864-8762
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01066978A IN Primary

Addresses

Primary practice location

3510 S Lafountain St
Kokomo, IN 46902-3803

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 3

IdentifierTypeStateIssuer
P01270925OtherINRR MEDICARE
739698000MedicaidMN
200947320MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cpowless126185@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090722000142 IN Practitioner - Obstetrics/Gynecology 3971507823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Southern Illinois University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

3510 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 864-8765

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Jan 1, 2017 Accepting new patients
Community Physicians of Indiana Inc Obstetrics & Gynecology CurrentSince Jan 1, 2017 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

3509 S Reed Rd
Kokomo, IN 46902
Phone (765) 453-8550

3510 S Lafountain St
Kokomo, IN 46902
Phone (765) 864-5760

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

Interoperability endpoints

  • Direct secure messaging: cpowless126185@ecommunitydirect.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1093727620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-864-8765",
            "fax_number": "765-864-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWLESS",
        "first_name": "CECELIA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01066978A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01270925",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "739698000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200947320",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpowless126185@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "3510 S LaFountain St",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469023803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.