Clinic at Home

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

71004940A Issued in IN

Legal business name

CLINIC AT HOME

Practice address

14675 Christie Ann Dr
Fishers, IN 46040-9682

Phone

(732) 861-3749

NPI assigned

Oct 12, 2015

Last updated

Oct 12, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mercy Moto, NURSE PRACTITIONER

Title

Owner

Phone

(732) 861-3749

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1467823880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14675 CHRISTIE ANN DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460409682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14675 CHRISTIE ANN DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460409682",
            "telephone_number": "732-861-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "MOTO",
        "authorized_official_first_name": "MERCY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-861-3749",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IN",
            "license": "71004940A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Fishers, IN
• Providers in Fishers, IN by specialty
• Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.