Active NPI
Chad Emerson Childers, DO
- Psychiatry Physician
- Indianapolis, IN
National Provider Identifier
1407601628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2084P0800X
- Practice address
- 355 W 16TH St Ste 2364
Indianapolis, IN 46202-2279 - Phone
- (260) 229-7006
- NPI assigned
- Apr 22, 2024
- Last updated
- Apr 22, 2024
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2084P0800X | IN | Primary |
Addresses
Primary practice location
355 W 16TH St Ste 2364
Indianapolis, IN 46202-2279
Mailing address
355 W 16TH St
Indianapolis, IN 46202-2207
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240530002771 | IN | Order and Referring Only - Psychiatry | 1355783721 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2084P0800X | IN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1407601628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 W 16TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 W 16TH ST STE 2364",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022279",
"telephone_number": "260-229-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDERS",
"first_name": "CHAD",
"middle_name": "EMERSON",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-22",
"last_updated": "2024-04-22",
"certification_date": "2024-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "2084P0800X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
- Bryton Chikukwa
- Nneoma Chikwendu, RN
- Kimberlee Chilcote
- Child and Family Wellness Center
- Shannon L Childers-Page, CNS
- Donald Lee Childers, LCSW
- Jennifer May Childers, RN
- Lisa S Childers, MD
- Children Express Care Clinic LLC (Children Express Care Clinic)
- Children's Bureau, Inc. (Firefly Children and Family Alliance)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.