NPIMap

Organization Active NPI

Christian Theological Seminary

  • Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1205030954
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01019810A Issued in IN
Legal business name
CHRISTIAN THEOLOGICAL SEMINARY
Practice address
1050 W 42ND St
Indianapolis, IN 46208-3301
Phone
(317) 924-5205
Fax
(317) 931-2393
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Authorized official

Name
Ms. Marcey Smith
Title
Billing Supervisor
Phone
(317) 955-2499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 01019810A IN Primary

Addresses

Primary practice location

1050 W 42ND St
Indianapolis, IN 46208-3301

Mailing address

1000 W 42ND St
Indianapolis, IN 46208-3301
Phone (317) 924-5205

Other identifiers 2

IdentifierTypeStateIssuer
200196670AMedicaidIN
000000216006OtherINANTHEM GROUP NUMBER

Other names 1

  • Counseling Center Other name

National Provider Directory

National Provider Directory

Locations

1000 W 42nd St
Indianapolis, IN 46208
Phone (317) 924-5205

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1205030954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 42ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462083301",
            "telephone_number": "317-924-5205",
            "fax_number": "317-931-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W 42ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462083301",
            "telephone_number": "317-924-5205",
            "fax_number": "317-931-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN THEOLOGICAL SEMINARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARCEY",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "317-955-2499",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01019810A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200196670A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "000000216006",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counseling Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 4, 2010; 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.