Organization Active NPI

Service Above Self, LLC

  • Exclusive Provider Organization
  • Indianapolis, IN
National Provider Identifier
1427061407
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
SERVICE ABOVE SELF, LLC
Practice address
3919 Meadows Dr
Box 421441
Indianapolis, IN 46205-3113
Phone
(317) 541-1836
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Mr. Austin O Nwaka, CEONPI 1073774485
Title
President
Phone
(317) 541-1836

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Primary

Addresses

Primary practice location

3919 Meadows Dr
Box 421441
Indianapolis, IN 46205-3113

Mailing address

3919 Meadows Dr
Indianapolis, IN 46205-3113
Phone (317) 541-1836

Other identifiers 1

IdentifierTypeStateIssuer
200427340MedicaidIN

National Provider Directory

National Provider Directory

Locations

3919 Meadows Dr
#421441
Indianapolis, IN 46205
Phone (317) 541-1836

3919 Meadows Dr
Indianapolis, IN 46205
Phone (317) 541-1836

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1427061407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 MEADOWS DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053113",
            "telephone_number": "317-541-1836",
            "fax_number": "317-541-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 MEADOWS DR",
            "address_2": "BOX 421441",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053113",
            "telephone_number": "317-541-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICE ABOVE SELF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "NWAKA",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-541-1836",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200427340",
            "state": "IN"
        }
    ],
    "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 Jul 30, 2008; 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.