NPIMap

Organization Active NPI

Indy Integrative Medicine, LLC

  • Family Medicine Physician
  • Plainfield, IN
National Provider Identifier
1437515574
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01047177A Issued in IN
Legal business name
INDY INTEGRATIVE MEDICINE, LLC
Practice address
2680 E Main St
Ste 309
Plainfield, IN 46168-2825
Phone
(260) 579-7683
NPI assigned
Jan 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Authorized official

Name
Dr. Charnjit S Pabla, MD
Title
Owner
Phone
(260) 579-7683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01047177A IN Primary

Addresses

Primary practice location

2680 E Main St
Ste 309
Plainfield, IN 46168-2825

Mailing address

2680 E Main St
Ste 309
Plainfield, IN 46168-2825
Phone (260) 579-7683

National Provider Directory

National Provider Directory

Locations

2680 E Main St
Ste 309
Plainfield, IN 46168
Phone (260) 579-7683

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1437515574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 E MAIN ST",
            "address_2": "STE 309",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682825",
            "telephone_number": "260-579-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 E MAIN ST",
            "address_2": "STE 309",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682825",
            "telephone_number": "260-579-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY INTEGRATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "PABLA",
        "authorized_official_first_name": "CHARNJIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-579-7683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01047177A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.