Active NPI
Paul Damian Jarvis, MD
- Pediatrics Physician
- Carmel, IN
National Provider Identifier
1104809300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01034243A
- Practice address
- 14828 Greyhound CT Ste 190
Carmel, IN 46032-5016 - Phone
- (317) 582-9000
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01034243A | IN | Primary |
Addresses
Primary practice location
14828 Greyhound CT Ste 190
Carmel, IN 46032-5016
Mailing address
8840 Commerce Park PL Ste E
Indianapolis, IN 46268-3129
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100362300 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454889600000",
"number": "1104809300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8840 COMMERCE PARK PL STE E",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462683129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14828 GREYHOUND CT STE 190",
"city": "CARMEL",
"state": "IN",
"postal_code": "460325016",
"telephone_number": "317-582-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIS",
"first_name": "PAUL",
"middle_name": "DAMIAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2016-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01034243A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100362300",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.