NPIMap

Organization Active NPI

Indianapolis Neurosurgical Group

Doing business as Goodman Campbell Brain and Spine

  • Magnetic Resonance Imaging Radiologic Technologist
  • Indianapolis, IN
National Provider Identifier
1154541753
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X
Legal business name
INDIANAPOLIS NEUROSURGICAL GROUP
Doing business as
Goodman Campbell Brain and Spine
Practice address
1925 N. Capitol Avenue
Indianapolis, IN 46202
Phone
(317) 396-1300
NPI assigned
Apr 26, 2007
Last updated
Dec 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Derek Cantrell
Title
Exec Director Finance
Phone
(317) 396-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging Radiologic Technologist 2471M1202X NU Primary

Addresses

Primary practice location

1925 N. Capitol Avenue
Indianapolis, IN 46202

Mailing address

8333 Naab Rd
255
Indianapolis, IN 46260-5924
Phone (317) 396-1300

Other identifiers 1

IdentifierTypeStateIssuer
100318390RMedicaidIN

Other names 1

  • Goodman Campbell Brain and Spine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goodman Campbell Brain and Spine21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

1925 N Capitol Ave
Indianapolis, IN 46202

8333 Naab Rd
#255
Indianapolis, IN 46260

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1154541753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD",
            "address_2": "255",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605924",
            "telephone_number": "317-396-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 N. CAPITOL AVENUE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-396-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS NEUROSURGICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "EXEC DIRECTOR FINANCE",
        "authorized_official_telephone_number": "317-396-1300"
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100318390R",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodman Campbell Brain and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 29, 2009; 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.