NPIMap

Organization Active NPI

Circle City Medical Group, LLC

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1467573063
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CIRCLE CITY MEDICAL GROUP, LLC
Practice address
3850 Shore Dr
Suite 113
Indianapolis, IN 46254-5621
Phone
(317) 298-0000
Fax
(317) 398-0011
NPI assigned
Apr 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Angela Lynn Johnson, M.D.NPI 1346257789
Title
Managing Partner
Phone
(317) 298-0000

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3850 Shore Dr
Suite 113
Indianapolis, IN 46254-5621

Mailing address

3850 Shore Dr
Suite 113
Indianapolis, IN 46254-5621
Phone (317) 298-0000

National Provider Directory

National Provider Directory
Tax ID family
Circle City Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

303 N Alabama St
Ste 230
Indianapolis, IN 46204
Phone (317) 916-9946

3266 N Meridian St
#706
Indianapolis, IN 46208
Phone (317) 926-3939

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467573063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 SHORE DR",
            "address_2": "SUITE 113",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545621",
            "telephone_number": "317-298-0000",
            "fax_number": "317-398-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 SHORE DR",
            "address_2": "SUITE 113",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545621",
            "telephone_number": "317-298-0000",
            "fax_number": "317-398-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE CITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "317-298-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 Aug 22, 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.