Individual provider Active NPI

Judith Syril Cecil

  • Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1245284744
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01036555A Issued in IN
Practice address
5470 E 16TH St
Indianapolis, IN 46218-4861
Phone
(317) 355-5394
Fax
(317) 351-7804
NPI assigned
May 19, 2006
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
Psychiatry Physician 2084P0800X 01036555A IN Primary

Addresses

Primary practice location

5470 E 16TH St
Indianapolis, IN 46218-4861

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805
Phone (317) 621-7561

Other identifiers 1

IdentifierTypeStateIssuer
100323840AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcecil7360@eCommunityDirect.com Community Health Network, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141121000833 IN Practitioner - Psychiatry 0244452522 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01036555AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc CurrentSince Nov 1, 2014 Accepting new patients
Community Health Network, Inc Current Accepting new patients
Community Health Network, Inc Past Accepting new patients

Locations

1640 N Ritter Ave
Indianapolis, IN 46218
Phone (317) 355-3104

5470 E 16th St
Indianapolis, IN 46218
Phone (317) 355-5009

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

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

Interoperability endpoints

  • Direct secure messaging: jcecil7360@ecommunitydirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1245284744",
    "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": "462502805",
            "telephone_number": "317-621-7561",
            "fax_number": "317-355-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5470 E 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184861",
            "telephone_number": "317-355-5394",
            "fax_number": "317-351-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECIL",
        "first_name": "JUDITH",
        "middle_name": "SYRIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01036555A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100323840A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcecil7360@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Network, Inc",
            "address_1": "6950 Hillsdale Ct",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.