Active NPI
Serenity Medical Center West LLC
- Psychiatry Physician
- Fishers, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- SERENITY MEDICAL CENTER WEST LLC
- Practice address
- 10765 Lantern Road
Suite 202
Fishers, IN 46038-3597 - Phone
- (317) 621-4170
- Fax
- (317) 621-4182
- NPI assigned
- Oct 6, 2011
- Last updated
- Jun 20, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Syed J Khan, MD
- Title
- Partner
- Phone
- (317) 621-4170
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | NU | ||
| Psychiatry Physician | 2084P0800X | NU | Primary |
Addresses
Primary practice location
10765 Lantern Road
Suite 202
Fishers, IN 46038-3597
Mailing address
10765 Lantern Road
Suite 202
Fishers, IN 46038-3597
Phone (317) 621-4170
National Provider Directory
National Provider DirectoryLocations
10765 Lantern Rd
Ste 110
Fishers, IN 46038
Phone (317) 621-4170
10765 Lantern Rd
Ste 202
Fishers, IN 46038
Phone (317) 621-4170
Practitioners & affiliated clinicians
Practitioners 5
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.
-
- Psychiatry Physician
- Berwyn, IL
- NPI 1407807746
-
- Psychiatry Physician
- Indianapolis, IN
- NPI 1619909991
-
- Addiction Medicine (Internal Medicine) Physician
- Indianapolis, IN
- NPI 1740385525
-
- Clinical Social Worker
- Indianapolis, IN
- NPI 1811058811
-
- Mental Health Counselor
- Indianapolis, IN
- NPI 1750315156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1340150400000",
"number": "1467736561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10765 LANTERN ROAD",
"address_2": "SUITE 202",
"city": "FISHERS",
"state": "IN",
"postal_code": "460383597",
"telephone_number": "317-621-4170",
"fax_number": "317-621-4182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10765 LANTERN ROAD",
"address_2": "SUITE 202",
"city": "FISHERS",
"state": "IN",
"postal_code": "460383597",
"telephone_number": "317-621-4170",
"fax_number": "317-621-4182"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SERENITY MEDICAL CENTER WEST LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-06",
"last_updated": "2012-06-20",
"status": "A",
"authorized_official_last_name": "KHAN",
"authorized_official_first_name": "SYED",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "317-621-4170",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.