Neuro Health Indianapolis LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NEURO HEALTH INDIANAPOLIS LLC

Doing business as

Genesis Lifestyle Medicine

Practice address

1553 W Oak St
Zionsville, IN 46077-1840

Phone

(760) 835-8962

NPI assigned

Oct 21, 2020

Last updated

Feb 8, 2021By 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

Alex Spinoso, MD

Title

Authorized Official

Phone

(725) 867-3337

Specialties & licenses 1

Addresses

Other names 1

• Genesis Lifestyle Medicine Doing business as

Locations

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1417556465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 W OAK ST",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771840",
            "telephone_number": "760-835-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 W OAK ST",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771840",
            "telephone_number": "760-835-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO HEALTH INDIANAPOLIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "SPINOSO",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "725-867-3337",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Lifestyle Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Genesis Lifestyle Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Zionsville, IN
• Providers in Zionsville, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.