NPIMap

Organization Active NPI

Diagnostic Rheumatology and Research, PC

  • Research Study Specialist
  • Indianapolis, IN
National Provider Identifier
1265457774
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Research Study SpecialistTaxonomy code 1744R1102X
License
61026374A Issued in IN
Legal business name
DIAGNOSTIC RHEUMATOLOGY AND RESEARCH, PC
Practice address
6447 S East St Ste a
Indianapolis, IN 46227-2119
Phone
(317) 859-6364
Fax
(317) 859-7537
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Authorized official

Name
Dr. Michael T Stack, MD PHD
Title
Owner
Phone
(317) 859-6364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Research Study SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 1744R1102X 61026374A IN Primary

Addresses

Primary practice location

6447 S East St Ste a
Indianapolis, IN 46227-2119

Mailing address

6447 S East St Ste a
Indianapolis, IN 46227-2119
Phone (317) 859-6364

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1265457774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6447 S EAST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272119",
            "telephone_number": "317-859-6364",
            "fax_number": "317-859-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6447 S EAST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272119",
            "telephone_number": "317-859-6364",
            "fax_number": "317-859-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC RHEUMATOLOGY AND RESEARCH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-859-6364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "1744R1102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Research Study",
            "state": "IN",
            "license": "61026374A",
            "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 Dec 20, 2011; 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.