Individual provider Active NPI

Laura E Boggs, PSYD

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1407173156
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042620A Issued in IN
Practice address
6640 Intech Blvd
Indianapolis, IN 46278-2011
Phone
(317) 274-8812
Fax
(317) 274-0133
NPI assigned
Apr 20, 2010
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001985A IN
Clinical Psychologist 103TC0700X 20042620A IN Primary

Addresses

Primary practice location

6640 Intech Blvd
Indianapolis, IN 46278-2011

Mailing address

PO Box 778912
Chicago, IL 60677-8912
Phone (317) 777-6435

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121029000010 IN Practitioner - Clinical Psychologist 9931359973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Pediatric Associates IncGroup PAC ID 2163326794, 100 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 944-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39001985AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
University Pediatric Associates, Inc. CurrentSince Jan 1, 2025 Accepting new patients

Locations

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

6640 Intech Blvd
Ste 195
Indianapolis, IN 46278
Phone (317) 295-0608

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

Interoperability endpoints

  • Direct secure messaging: lboggs@direct.iuhealth.org

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": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1407173156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778912",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778912",
            "telephone_number": "317-777-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 INTECH BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462782011",
            "telephone_number": "317-274-8812",
            "fax_number": "317-274-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001985A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042620A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.