Divine Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

DIVINE DIAGNOSTICS LLC

Practice address

2608 W 44TH St
Indianapolis, IN 46228-2037

Phone

(317) 294-5808

NPI assigned

Jan 9, 2022

Organization subpart

No

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

Authorized official

Name

Patrice Ellis, RN

Title

Ceo

Phone

(317) 294-5808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1641686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641686400000",
    "number": "1265193429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 W 44TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462282037",
            "telephone_number": "317-294-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 W 44TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462282037",
            "telephone_number": "317-294-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-09",
        "last_updated": "2022-01-09",
        "certification_date": "2022-01-09",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-294-5808",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diverse Dimensions Behavior Consulting LLC
• Diverse Network Analytics
• Diversified Concepts/City Solutions Inc.
• Divias Care LLC
• Amy Divincenzo, MSW
• Divine Directions LLC
• Divine Harmony Home Health Care
• Divine Harmony LLP
• Divine Healthcare LLC
• Divine Home Health, LLC

• Clinical Medical Laboratory in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2022; 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.