NPIMap

Organization Active NPI

Indiana University School of Medicine

  • Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1225296734
Registry record updated Dec 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
11012602A Issued in IN
Legal business name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Practice address
545 Barnhill Dr
Emerson Hall 203
Indianapolis, IN 46202-5112
Phone
(317) 274-5000
NPI assigned
May 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2008

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

Authorized official

Name
Dr. Alyssa Danielle Fajardo, MD
Title
Surgery Resident
Phone
(317) 312-0265

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 11012602A IN Primary
General Acute Care Hospital 282N00000X 11012062A IN

Addresses

Primary practice location

545 Barnhill Dr
Emerson Hall 203
Indianapolis, IN 46202-5112

Mailing address

6015 Maple Forge Cir
Indianapolis, IN 46254-1266

National Provider Directory

National Provider Directory

Locations

545 Barnhill Dr
#203
Indianapolis, IN 46202
Phone (317) 274-3086

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1225296734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 MAPLE FORGE CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BARNHILL DR",
            "address_2": "EMERSON HALL 203",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025112",
            "telephone_number": "317-274-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY SCHOOL OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "SURGERY RESIDENT",
        "authorized_official_telephone_number": "317-312-0265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IN",
            "license": "11012602A",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IN",
            "license": "11012062A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 22, 2008; 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.