NPIMap

Organization Active NPI

Cardiothoracic Surgeons Pediatrics LLC

  • Pediatric Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1154537850
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
CARDIOTHORACIC SURGEONS PEDIATRICS LLC
Practice address
545 Barnhill Dr # Eh215
Indianapolis, IN 46202-5112
Phone
(317) 948-0944
NPI assigned
May 16, 2007
Last updated
Dec 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Authorized official

Name
Teresa Kruse
Title
Business Line Administrator
Phone
(317) 948-0944

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X NU
Surgery Physician 208600000X NU
Pediatric Surgery Physician 2086S0120X NU Primary
Plastic and Reconstructive Surgery Physician 2086S0122X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU

Addresses

Primary practice location

545 Barnhill Dr # Eh215
Indianapolis, IN 46202-5112

Mailing address

PO Box 636762
Cincinnati, OH 45263-0001
Phone (317) 948-7048

National Provider Directory

National Provider Directory

Locations

545 Barnhill Dr
#215
Indianapolis, IN 46202
Phone (317) 274-7949

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1154537850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636762",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "317-948-7048",
            "fax_number": "317-274-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BARNHILL DR # EH215",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025112",
            "telephone_number": "317-948-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOTHORACIC SURGEONS PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "BUSINESS LINE ADMINISTRATOR",
        "authorized_official_telephone_number": "317-948-0944"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 6, 2018; 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.