NPIMap

Organization Active NPI

Axon Network Services, LLC

  • Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1124535109
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
AXON NETWORK SERVICES, LLC
Practice address
9245 N Meridian St Ste 300
Indianapolis, IN 46260-1832
Phone
(317) 818-9000
Fax
(317) 818-9009
NPI assigned
Dec 29, 2017
Organization subpart
Yes
Parent organization
AXON HEALTH ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Authorized official

Name
Dr. Jerad Dalton, DONPI 1306835418
Title
Owner / Provider
Phone
(317) 818-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

9245 N Meridian St Ste 300
Indianapolis, IN 46260-1832

Mailing address

9245 N Meridian St Ste 300
Indianapolis, IN 46260-1832
Phone (317) 818-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250211001719 IN Part B Supplier - Clinic/Group Practice 0143750844 Receives reassigned benefits from 5 practitioners
Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory
Part of
Axon Health Associates LLC

Locations

9245 N Meridian St
Ste 225
Indianapolis, IN 46260
Phone (317) 818-9000

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1124535109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 N MERIDIAN ST STE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601832",
            "telephone_number": "317-818-9000",
            "fax_number": "317-818-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 N MERIDIAN ST STE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601832",
            "telephone_number": "317-818-9000",
            "fax_number": "317-818-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXON NETWORK SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AXON HEALTH ASSOCIATES, LLC",
        "enumeration_date": "2017-12-29",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "JERAD",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "317-818-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.