Indiana Neuromonitoring LLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

INDIANA NEUROMONITORING LLC

Practice address

7310 Greenview Dr
Battle Ground, IN 47920-9729

Phone

(800) 301-7334

NPI assigned

Mar 22, 2019

Last updated

May 21, 2019By 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

Mario Brkaric, MD

Title

Member

Phone

(800) 301-7334

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1194285460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT # 880303 PO BOX 29650",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389650",
            "telephone_number": "800-301-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 GREENVIEW DR",
            "city": "BATTLE GROUND",
            "state": "IN",
            "postal_code": "479209729",
            "telephone_number": "800-301-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA NEUROMONITORING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "BRKARIC",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "800-301-7334",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN MEDICAL LIC",
            "identifier": "01061882A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Catherine Ahlenius, RD, LD
• Lucas Mansfield, PHARMD
• Antonya Prior
• Spectrum Community Services of Indiana LLC
• Callie Marie Stoneking, OTR
• Brooke Szipszky, OTR/L

• Electrodiagnostic Medicine Physician in Battle Ground, IN
• Providers in Battle Ground, IN by specialty
• Electrodiagnostic Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.