Avon Pediatrics PC
Organization Active NPI Pediatrics Physician · Avon, IN
NPI 1275747313 · NPPES record last updated Dec 23, 2008
Key facts
- NPI
- 1275747313
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 01044494 (IN)
- Legal business name
- AVON PEDIATRICS PC
- Practice address
- 7376 Business Center Dr
Suite a
Avon, IN 46123-8662 - Phone
- (317) 272-7887
- Fax
- (317) 272-7888
- NPI assigned
- May 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Kerry L Hensley, M.D.
- Title
- Owner
- Phone
- (317) 272-7887
Practitioners 3
-
Erik D. Cox, M.D.
-
Donna Russell Venturini, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0996179 | Avon Pediatrics PC | Certificate of waiver | Feb 11, 2028 |
National Provider Directory
Locations
7376 Business Center Dr
Avon, IN 46123
Phone (317) 272-7887
7376 Business Center Dr
#A
Avon, IN 46123
Phone (317) 272-7887
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 01044494 | IN | Yes |
Addresses
Primary practice location
7376 Business Center Dr
Suite a
Avon, IN 46123-8662
Mailing address
7376 Business Center Dr
Suite a
Avon, IN 46123-8662
Phone (317) 272-7887
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200140570 | Medicaid | IN |
Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.