Individual provider Active NPI

Holly Wheeler, DO

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1285921031
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02004265A Issued in IN
Practice address
10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2663
Phone
(317) 355-5913
Fax
(317) 355-3760
NPI assigned
Jun 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02004265A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X 11016162A IN

Addresses

Primary practice location

10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2663

Mailing address

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2890

Other identifiers 2

IdentifierTypeStateIssuer
P01512450OtherINRR MEDICARE
201068200MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140811001085 IN Practitioner - General Practice 7113166364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

10122 E 10TH St
Suite 100
Indianapolis, IN 46229-2697
Phone (317) 355-5717

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02004265AINMDFamily Medicine Physician
11016162AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Aug 25, 2014 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 25, 2014 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

533 E County Line Rd
Ste 101
Greenwood, IN 46143
Phone (317) 497-6920

2040 N Shadeland Ave
Ste 300
Indianapolis, IN 46219
Phone (317) 355-3232

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

10122 E 10th St
Ste 100
Indianapolis, IN 46229
Phone (317) 355-5717

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • Direct secure messaging: hwheeler11791@ecommunitydirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1285921031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292663",
            "telephone_number": "317-355-5913",
            "fax_number": "317-355-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "HOLLY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02004265A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11016162A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01512450",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201068200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.