Individual provider Active NPI

Mery A Kendall, MD

  • Family Medicine Physician
  • Greenwood, IN
National Provider Identifier
1164691150
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01066320A Issued in IN
Practice address
333 E County Line Rd
Suite B
Greenwood, IN 46143-1046
Phone
(317) 497-6333
Fax
(317) 497-6334
NPI assigned
Feb 25, 2008
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01066320A IN Primary

Addresses

Primary practice location

333 E County Line Rd
Suite B
Greenwood, IN 46143-1046

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 4

IdentifierTypeStateIssuer
000000680971OtherINANTHEM
000000652750OtherINANTHEM
200964080MedicaidIN
P01157049OtherINRR MEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkendall11758@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091006000686 IN Practitioner - Family Practice 4880730753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

333 E County Line Rd
Suite B
Greenwood, IN 46143-1080
Phone (317) 497-6333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01066320AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Dec 1, 2010 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 1, 2010 Accepting new patients
Major Hospital Past Accepting new patients
Community Health Network, Inc Past Accepting new patients
Community Hospitals of Indiana Inc Family Medicine Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1600 Albany St
Beech Grove, IN 46107
Phone (317) 783-8148

333 E County Line Rd
Ste B
Greenwood, IN 46143
Phone (317) 497-6333

1250 N Post Rd
Ste B
Indianapolis, IN 46219
Phone (317) 898-2197

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

8075 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-8000

Interoperability endpoints

  • Direct secure messaging: mkendall11758@ecommunitydirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1164691150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E COUNTY LINE RD",
            "address_2": "SUITE B",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431046",
            "telephone_number": "317-497-6333",
            "fax_number": "317-497-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "MERY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01066320A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000680971",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000652750",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200964080",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01157049",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkendall11758@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "333 E County Line Rd",
            "address_2": "Suite B",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.