Indiana Re-Entry Integrated Services

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

INDIANA RE-ENTRY INTEGRATED SERVICES

Practice address

3301 Brouse Ave
Indianapolis, IN 46218-2018

Phone

(317) 263-6573

NPI assigned

Jan 18, 2023

Last updated

Jan 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Dwayne James, LCAC

Title

Ceo

Phone

(317) 263-6573

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Kenisha Renee Peden, LCSW

  • Social Worker
  • Martinsville, IN
  • NPI 1033825831
  NPD

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1164137659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BROUSE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462182018",
            "telephone_number": "317-263-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BROUSE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462182018",
            "telephone_number": "317-263-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA RE-ENTRY INTEGRATED SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DWAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-263-6573",
        "authorized_official_credential": "LCAC"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenisha.peden@indianare-entryintegratedservices.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3301 Brouse Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462182018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Indiana Physician Management, LLC
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• Indiana Psychiatry PC
• Indiana Radiation Oncology, LLC
• Indiana Radiology Partners, Inc
• Indiana Regenerative Medicine Institute LLC
• Indiana Regional Foot & Ankle Center PC
• Indiana School for the Deaf
• Indiana Spine and Pain Center Inc
• Indiana Spine Care, LLC

• Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.