Indy Adult Medicine, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

INDY ADULT MEDICINE, LLC

Practice address

3850 Shore Dr
Suite 113
Indianapolis, IN 46254-2609

Phone

(317) 298-0000

Fax

(317) 298-0011

NPI assigned

Feb 18, 2008

Last updated

Dec 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angela Lynn Johnson, M.D.

Title

Partner

Phone

(317) 298-0000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387756800000",
    "number": "1376711911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 SHORE DR",
            "address_2": "SUITE 113",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542609",
            "telephone_number": "317-298-0000",
            "fax_number": "317-298-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 SHORE DR",
            "address_2": "SUITE 113",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542609",
            "telephone_number": "317-298-0000",
            "fax_number": "317-298-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY ADULT MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2013-12-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "317-298-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Indy Airport Taxi Inc
• Indy Anesthesia Associates LLC
• Indy Anesthesia Services, LLC.

• Specialist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; 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.