Kexia Van
Individual provider Active NPI Family Medicine Physician · Indianapolis, IN
NPI 1154856151 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1154856151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 02005573A (IN)
- Practice address
- 5908 E Stop 11 Rd
Indianapolis, IN 46237-8683 - Phone
- (317) 497-6800
- Fax
- (317) 497-6801
- NPI assigned
- Apr 27, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200720000008 | IN | Practitioner - Osteopathic Manipulative Medicine | 4587930284 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Family Medicine | Current |
Accepting new patients |
| Community Physicians of Indiana Inc | Current |
Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Everside Health, LLC | Past | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
5908 E Stop 11 Rd
Indianapolis, IN 46237
Phone (317) 497-6800
Interoperability endpoints
- kvan164640@ecommunitydirect.com
- kexia.van.1@14940.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 02005573A | IN | |
| Family Medicine Physician | 207Q00000X | 02005573A | IN | Yes |
Addresses
Primary practice location
5908 E Stop 11 Rd
Indianapolis, IN 46237-8683
Mailing address
6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7547
Other practice location 1
3200 Cold Spring Rd
Apt 221
Indianapolis, IN 46222-1960
Phone (630) 888-5609
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kvan164640@eCommunityDirect.com | Community Physicians of Indiana Inc |
Other providers in Indianapolis, IN
- David Van Winkle
- Melissa Van Wormer
- Christian Chenae Van Zee
- Baotram Van
- Darrika Denise Van
- Mindy M Van
- Dawn Vanblarcum
- Allyssa Vanbuskirk
- Melissa Dawn Vance-Blackwell
- Ashley Vance
All providers in Indianapolis, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.