Individual provider Active NPI

Cruz Maria Medina Ochoa

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1417588963
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008726A Issued in IN
Practice address
2240 N Meridian St
Indianapolis, IN 46208-5728
Phone
(317) 644-7983
NPI assigned
Feb 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34008726A IN Primary

Addresses

Primary practice location

2240 N Meridian St
Indianapolis, IN 46208-5728

Mailing address

2240 N Meridian St
Indianapolis, IN 46208-5728
Phone (317) 644-7983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34008726AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1417588963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462085728",
            "telephone_number": "317-644-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462085728",
            "telephone_number": "317-644-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA OCHOA",
        "first_name": "CRUZ",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008726A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.