Individual provider Active NPI

Judith C Vahle, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1386813210
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01067683A Issued in IN
Practice address
1303 N Arlington Ave
Suite # 2
Indianapolis, IN 46219-8300
Phone
(317) 359-9671
Fax
(317) 359-9672
NPI assigned
Feb 25, 2008
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01067683A IN Primary

Addresses

Primary practice location

1303 N Arlington Ave
Suite # 2
Indianapolis, IN 46219-8300

Mailing address

6626 E. 75TH Street
Suite # 500
Indianapolis, IN 46250-2890
Phone (317) 355-7199

Other identifiers 2

IdentifierTypeStateIssuer
200990950MedicaidIN
P01009918OtherINRR MEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jvahle10740@eCommunityDirect.com Community Physicians of Indiana Inc

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
I20100803001266 IN Practitioner - Family Practice 5890828420 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Mar 16, 2011 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Mar 16, 2011 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1303 N Arlington Ave
Ste 2
Indianapolis, IN 46219
Phone (317) 359-2237

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

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

7910 E Washington St
Ste 300
Indianapolis, IN 46219
Phone (317) 355-9220

Interoperability endpoints

  • Direct secure messaging: jvahle10740@ecommunitydirect.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1386813210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E. 75TH STREET",
            "address_2": "SUITE # 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-355-7199",
            "fax_number": "317-355-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 N ARLINGTON AVE",
            "address_2": "SUITE # 2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462198300",
            "telephone_number": "317-359-9671",
            "fax_number": "317-359-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHLE",
        "first_name": "JUDITH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01067683A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200990950",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01009918",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvahle10740@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1303 N Arlington Ave",
            "address_2": "Suite # 2",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462198300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.