Active NPI
Divya Wilson Mathews, M.S
- Genetic Counselor (M.S.)
- Indianapolis, IN
National Provider Identifier
1245505577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Genetic Counselor (M.S.)
- License
- 99049858A
- Practice address
- 8091 Township Line Rd
Suite 108
Indianapolis, IN 46260-2494 - Phone
- (317) 415-7742
- NPI assigned
- Mar 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Genetic Counselor (M.S.) | 170300000X | 99049858A | IN | Primary |
Addresses
Primary practice location
8091 Township Line Rd
Suite 108
Indianapolis, IN 46260-2494
Mailing address
8091 Township Line Rd
Suite 108
Indianapolis, IN 46260-2494
Phone (317) 415-7742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99049858A | IN | MD | Genetic Counselor (M.S.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332201600000",
"number": "1245505577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8091 TOWNSHIP LINE RD",
"address_2": "SUITE 108",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602494",
"telephone_number": "317-415-7742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8091 TOWNSHIP LINE RD",
"address_2": "SUITE 108",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602494",
"telephone_number": "317-415-7742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON MATHEWS",
"first_name": "DIVYA",
"name_prefix": "Miss",
"credential": "M.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-20",
"last_updated": "2012-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "170300000X",
"taxonomy_group": "",
"desc": "Genetic Counselor, MS",
"state": "IN",
"license": "99049858A",
"primary": true
}
],
"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 Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.