Pro Surge Indy LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PRO SURGE INDY LLC

Practice address

4725 Statesmen Dr Ste B
Indianapolis, IN 46250-5645

Phone

(480) 930-4018

NPI assigned

Feb 4, 2019

Organization subpart

No

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

Authorized official

Name

Kristy Morgan, DC

Title

Member

Phone

(623) 935-9920

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1114482122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462085854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 STATESMEN DR STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505645",
            "telephone_number": "480-930-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO SURGE INDY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "623-935-9920",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pain Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.