Active NPI
William M Tierney, MD
- Internal Medicine Physician
- Indianapolis, IN
National Provider Identifier
1366490641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01027180A
- Practice address
- 1002 Wishard Blvd
4TH FL
Indianapolis, IN 46202-2872 - Phone
- (317) 692-2323
- Fax
- (317) 656-3967
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01027180A | IN | Primary |
Addresses
Primary practice location
1002 Wishard Blvd
4TH FL
Indianapolis, IN 46202-2872
Mailing address
410 W 10TH St
Suite Hs2000
Indianapolis, IN 46202-3010
Phone (317) 630-7660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200478510 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01027180A | IN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328054400000",
"number": "1366490641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 W 10TH ST",
"address_2": "SUITE HS2000",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462023010",
"telephone_number": "317-630-7660",
"fax_number": "317-630-2466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 WISHARD BLVD",
"address_2": "4TH FL",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022872",
"telephone_number": "317-692-2323",
"fax_number": "317-656-3967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIERNEY",
"first_name": "WILLIAM",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2012-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01027180A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200478510",
"state": "IN"
}
],
"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 Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.