Shantha Addison
Individual provider Active NPI In Home Supportive Care Agency · Indianapolis, IN
NPI 1104715341 · NPPES record last updated Jul 1, 2025
Key facts
- NPI
- 1104715341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- License
- 300113526 (IN)
- Practice address
- 3521 N Faculty Dr
Indianapolis, IN 46224-1285 - Phone
- (317) 970-5444
- NPI assigned
- Jul 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300113526 | IN | MD | In Home Supportive Care Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 300113526 | IN | Yes |
Addresses
Primary practice location
3521 N Faculty Dr
Indianapolis, IN 46224-1285
Mailing address
3521 N Faculty Dr
Indianapolis, IN 46224-1285
Phone (317) 970-5444
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All providers in Indianapolis, IN · In Home Supportive Care Agency in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.