Envision Diagnostic Services

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

ENVISION DIAGNOSTIC SERVICES

Practice address

4916 Birmingham Dr
Indianapolis, IN 46235-6103

Phone

(260) 312-6305

NPI assigned

Oct 24, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Chanel Jones, NPNPI 1013536358

Title

Owner

Phone

(260) 312-6305

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

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

• Chanel Jones, NP

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1013536358
  NPD Authorized official

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

{
    "created_epoch": "1635033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635033600000",
    "number": "1457015752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4916 BIRMINGHAM DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462356103",
            "telephone_number": "260-312-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 BIRMINGHAM DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462356103",
            "telephone_number": "260-312-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION DIAGNOSTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-24",
        "last_updated": "2021-10-24",
        "certification_date": "2021-10-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CHANEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-312-6305",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Indianapolis, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.