NPIMap

Organization Active NPI

Echo Prime LLC

  • Social Worker
  • Indianapolis, IN
National Provider Identifier
1124753868
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
ECHO PRIME LLC
Practice address
1520 E 72ND St Back
Indianapolis, IN 46240
Phone
(317) 565-3777
NPI assigned
Jul 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Liella Marie EncisoNPI 1396515896
Title
Supervisor
Phone
(317) 565-3777

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
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

1520 E 72ND St Back
Indianapolis, IN 46240

Mailing address

1520 E 72ND St
Indianapolis, IN 46240-3204
Phone (317) 565-3777

Other identifiers 1

IdentifierTypeStateIssuer
1699427229MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address supervisor@echoprime.org Direct
Direct Messaging Address julio.enciso@echoprime.org

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1124753868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 E 72ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462403204",
            "telephone_number": "317-565-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 E 72ND ST BACK",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46240",
            "telephone_number": "317-565-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECHO PRIME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "ENCISO",
        "authorized_official_first_name": "LIELLA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "317-565-3777"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699427229",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "supervisor@echoprime.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1520 E 72nd st BACK",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "julio.enciso@echoprime.org",
            "affiliation": "N",
            "address_1": "1520 E 72nd st BACK",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jul 18, 2022; 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.