Individual provider Active NPI

Meghan Kyle Fricke

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1104128214
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001248A Issued in IN
Practice address
860 E 86TH St Ste 4
Indianapolis, IN 46240
Phone
(317) 975-3441
NPI assigned
Nov 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001248A IN Primary

Addresses

Primary practice location

860 E 86TH St Ste 4
Indianapolis, IN 46240

Mailing address

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 398-5275

Other practice location 1

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 398-5275

Other practice location 2

675 E Hickory Ln
Indianapolis, IN 46227-8512
Phone (317) 883-7712

Other practice location 3

650 N Girls School Rd
Indianapolis, IN 46214-3672
Phone (317) 299-4033

Other practice location 4

1728 E State Road 44
Shelbyville, IN 46176-1846
Phone (317) 395-3788

Other practice location 5

10950 Pendleton Pike
Indianapolis, IN 46236-2843
Phone (317) 975-3441

Other identifiers 1

IdentifierTypeStateIssuer
000000713740OtherINANTHEM BC/BS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000639 IN Practitioner - Physician Assistant 4183808306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nora Urgent Care LLCGroup PAC ID 4486884871, 19 clinicians

Practice addresses (Care Compare)

860 E 86TH St
Indianapolis, IN 46240-6860
Phone (317) 975-3441

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001248AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nora Urgent Care LLC CurrentSince Jan 13, 2015 Accepting new patients
Greenway Trail Emergency Physicians LLC Past Accepting new patients
Icem-Ball, LLC Past Accepting new patients
Lafountain Emergency Physicians LLC Past Accepting new patients

Locations

675 E Hickory Ln
Indianapolis, IN 46227
Phone (317) 497-6390

860 E 86th St
Ste 4
Indianapolis, IN 46240
Phone (317) 975-3441

10950 Pendleton Pike
Indianapolis, IN 46236
Phone (317) 355-2470

1728 E State Road 44
Shelbyville, IN 46176
Phone (317) 395-3788

Organizations & group practices 5

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": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1104128214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W WASHINGTON ST",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461761236",
            "telephone_number": "317-398-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 E 86TH ST STE 4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46240",
            "telephone_number": "317-975-3441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "IN",
            "postal_code": "461761236",
            "country_code": "US",
            "telephone_number": "317-398-5275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 E Hickory Ln",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462278512",
            "country_code": "US",
            "telephone_number": "317-883-7712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 N Girls School Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462143672",
            "country_code": "US",
            "telephone_number": "317-299-4033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1728 E State Road 44",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "IN",
            "postal_code": "461761846",
            "country_code": "US",
            "telephone_number": "317-395-3788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10950 Pendleton Pike",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462362843",
            "country_code": "US",
            "telephone_number": "317-975-3441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "MEGHAN",
        "middle_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-22",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001248A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000713740",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.