Individual provider Active NPI

Naomi C. Lightburn, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1104087311
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01069655A Issued in IN
Practice address
550 N. University Blvd
Uh1501
Indianapolis, IN 46202-5149
Phone
(317) 948-1310
Fax
(317) 962-0503
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01069655A IN Primary

Addresses

Primary practice location

550 N. University Blvd
Uh1501
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959

Other identifiers 2

IdentifierTypeStateIssuer
N/AMedicaidIN
201029150MedicaidIN

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
I20110817000893 IN Practitioner - HospitalistPractitioner - Internal Medicine 2769651207 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-2443

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC CurrentSince Nov 15, 2024 Accepting new patients
University Family Physicians, Inc. Internal Medicine CurrentSince Apr 5, 2012 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Sep 4, 2018 Accepting new patients
Galen Inpatient Physicians, PC Internal Medicine CurrentSince Nov 15, 2024 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Sep 4, 2018 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC Internal Medicine CurrentSince Nov 1, 2016 Accepting new patients
University Family Physicians, Inc. CurrentSince Apr 5, 2012 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine Current Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

550 University Blvd
#1501
Indianapolis, IN 46202
Phone (317) 948-1310

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Interoperability endpoints

  • Direct secure messaging: nlightburn1158761@direct.trinity-health.org

Organizations & group practices 8

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1104087311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N. UNIVERSITY BLVD",
            "address_2": "UH1501",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-948-1310",
            "fax_number": "317-962-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTBURN",
        "first_name": "NAOMI",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01069655A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N/A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201029150",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.