NPIMap

Organization Active NPI

Urology of Indiana, L.L.C.

  • Customized Equipment (DME)
  • Greenwood, IN
National Provider Identifier
1205916830
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
UROLOGY OF INDIANA, L.L.C.
Practice address
679 E County Line Rd
Greenwood, IN 46143-1049
Phone
(317) 885-1250
Fax
(317) 859-4269
NPI assigned
Oct 17, 2006
Last updated
Mar 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Authorized official

Name
Dr. Bradley G Orris, M.D.NPI 1760496756
Title
M.D./ Owner
Phone
(317) 859-7222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU Primary

Addresses

Primary practice location

679 E County Line Rd
Greenwood, IN 46143-1049

Mailing address

679 E County Line Rd
Greenwood, IN 46143-1049
Phone (317) 885-1250

Other identifiers 3

IdentifierTypeStateIssuer
100194370NMedicaidIN
1487680518OtherINGROUP NPI
1225485899OtherINUROPOINT LAB NPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address urologyin@directaddress.net Urology of Indiana L.L.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930087249 IN DME Supplier - Physician - Urology 7517870009 Practice locations: Greenwood, IN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1205916830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-885-1250",
            "fax_number": "317-859-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-885-1250",
            "fax_number": "317-859-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY OF INDIANA, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "ORRIS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "M.D./ OWNER",
        "authorized_official_telephone_number": "317-859-7222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100194370N",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1487680518",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UROPOINT LAB NPI",
            "identifier": "1225485899",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urologyin@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Urology of Indiana L.L.C.",
            "address_1": "679 E County Line Rd",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.