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

LicenseStateTypeSpecialty
300113526INMDIn Home Supportive Care Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · In Home Supportive Care Agency in Indiana

Sources for this page

Verify at the official NPI Registry.