Organization Active NPI

Neurology Clinic of Indiana, PC

  • Neurology Physician
  • Indianapolis, IN
National Provider Identifier
1114941739
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01055906 Issued in IN
Legal business name
NEUROLOGY CLINIC OF INDIANA, PC
Practice address
8330 Naab Rd
Suite #102
Indianapolis, IN 46260-5925
Phone
(317) 870-6704
Fax
(317) 870-0499
NPI assigned
Jul 27, 2006
Last updated
Nov 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Wei Wang, MD
Title
President
Phone
(317) 870-6704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 01055906 IN Primary

Addresses

Primary practice location

8330 Naab Rd
Suite #102
Indianapolis, IN 46260-5925

Mailing address

PO Box 635361
Cincinnati, OH 45263-0043
Phone (317) 870-6704

Other identifiers 1

IdentifierTypeStateIssuer
200828640MedicaidIN

National Provider Directory

National Provider Directory

Locations

2101 Forest Ave
Ste 221
San Jose, CA 95128
Phone (408) 216-8763

7250 Clearvista Dr
Ste 390
Indianapolis, IN 46256
Phone (317) 228-1940

8330 Naab Rd
Ste 102
Indianapolis, IN 46260
Phone (317) 429-9336

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1114941739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635361",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630043",
            "telephone_number": "317-870-6704",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 NAAB RD",
            "address_2": "SUITE #102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605925",
            "telephone_number": "317-870-6704",
            "fax_number": "317-870-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CLINIC OF INDIANA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "WEI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-870-6704",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01055906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200828640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.