Advanced Gynecology & Pelvic Health Specialists, LLC

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

Legal business name

ADVANCED GYNECOLOGY & PELVIC HEALTH SPECIALISTS, LLC

Practice address

14540 Prairie Lakes Blvd N Ste 110
Noblesville, IN 46060-4370

Phone

(317) 982-5222

Fax

(317) 982-5223

NPI assigned

Jan 2, 2024

Last updated

Nov 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Blake, MDNPI 1477545127

Title

Owner

Phone

(765) 623-6226

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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.

• Jeffrey M Blake, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Noblesville, IN
  • NPI 1477545127
  Medicare reassignment NPD Authorized official
• Breanna Dawn Dove, PA-C

  • Physician Assistant
  • Noblesville, IN
  • NPI 1649964628
  NPD

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1265202105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14540 PRAIRIE LAKES BLVD N STE 110",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604370",
            "telephone_number": "317-982-5222",
            "fax_number": "317-982-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 PRAIRIE LAKES BLVD N STE 110",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604370",
            "telephone_number": "317-982-5222",
            "fax_number": "317-982-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GYNECOLOGY & PELVIC HEALTH SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-623-6226",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christen Hope Adam, PT, WCC
• Angela Kathryn Adams, MA, CCC/SLP
• Shannon K Adams, LCSW
• Shannon Adcock, DPT
• Eric Adolph, M.D.
• Advantage Chiropractic & Wellness LLC
• Michael A Agostino, MD
• Isabela Aguirre
• Imtiaz M Ahmad, M.D.
• Rehana Ahsan, RPH

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Noblesville, IN
• Providers in Noblesville, IN by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.