NPIMap

Organization Active NPI

Certified Physician Solutions

Doing business as Certified Physician Solutions, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1275802993
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
02003296A Issued in IN
Legal business name
CERTIFIED PHYSICIAN SOLUTIONS
Doing business as
Certified Physician Solutions, LLC
Practice address
541 N Park Ave
Indianapolis, IN 46202-3513
Phone
(574) 304-0428
Fax
(317) 602-7166
NPI assigned
Dec 27, 2011
Last updated
Feb 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Authorized official

Name
Dr. Joe Edward Banks II, D.O.NPI 1154508075
Title
Owner
Phone
(574) 304-0428

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 02003296A IN Primary

Addresses

Primary practice location

541 N Park Ave
Indianapolis, IN 46202-3513

Mailing address

541 N Park Ave
Indianapolis, IN 46202-3513
Phone (574) 304-0428

Other practice location 1

71366 Sanderling Dr
Niles, MI 49120-7666
Phone (574) 304-0428

Other names 1

  • Certified Physician Solutions, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550016000000",
    "number": "1275802993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 N PARK AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023513",
            "telephone_number": "574-304-0428",
            "fax_number": "317-602-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 N PARK AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023513",
            "telephone_number": "574-304-0428",
            "fax_number": "317-602-7166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71366 Sanderling Dr",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491207666",
            "country_code": "US",
            "telephone_number": "574-304-0428",
            "fax_number": "269-262-0519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CERTIFIED PHYSICIAN SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2019-02-13",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-304-0428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "02003296A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Certified Physician Solutions, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Certified Physician Solutions, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 13, 2019; 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.