Individual provider Active NPI

Jeremy R. Fields, PT, DPT, ATC/L

  • Physical Therapist
  • Carmel, IN
National Provider Identifier
1447419916
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05015824A Issued in IN
Practice address
10767 Illinois St Ste 3000
Carmel, IN 46032-8972
Phone
(317) 817-1200
Fax
(317) 817-1220
NPI assigned
Jun 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1620 CT
Athletic Trainer 2255A2300X 000413 CT
Physical Therapist 225100000X 05015824A IN Primary

Addresses

Primary practice location

10767 Illinois St Ste 3000
Carmel, IN 46032-8972

Mailing address

10767 Illinois St Ste 3000
Carmel, IN 46032-8972
Phone (317) 817-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241122000412 IN Practitioner - Physical Therapist in Private Practice 2163957598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10767 Illinois St
Suite 3000
Carmel, IN 46032-8972
Phone (317) 817-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000413CTMDMarriage & Family Therapist
05015824AINMDPhysical Therapist
1620CTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas a Brady Sports Medicine Center, PC Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Thomas a Brady Sports Medicine Center, PC Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Sacred Heart University, Inc Physical Therapist Past Accepting new patients
Anb-Ptsma Holdings, Inc. Physical Therapist PastSince Jun 18, 2007 Accepting new patients

Locations

10767 Illinois St
Ste 3000
Carmel, IN 46032
Phone (317) 708-6858

1401 W County Line Rd
Greenwood, IN 46142
Phone (317) 217-1200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1447419916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "JEREMY",
        "middle_name": "R.",
        "credential": "PT, DPT, ATC/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "1620",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "000413",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015824A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.