NPIMap

Organization Active NPI

Acorn Addiction Centers LLC Dba Journey Road Treatment Centers

Doing business as Journey Road Treatment Centers

  • Addiction Medicine (Family Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1467824698
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
ACORN ADDICTION CENTERS LLC DBA JOURNEY ROAD TREATMENT CENTERS
Doing business as
Journey Road Treatment Centers
Practice address
1201 N Post Road Ste. 4
Indianapolis, IN 46219-4225
Phone
(317) 405-8833
Fax
(317) 672-2398
NPI assigned
Oct 27, 2015
Last updated
Jan 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Mari Anna Shepherd
Title
Director
Phone
(317) 405-8833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X NU Primary

Addresses

Primary practice location

1201 N Post Road Ste. 4
Indianapolis, IN 46219-4225

Mailing address

1201 N Post Road Ste. 4
Indianapolis, IN 46219-4225
Phone (317) 405-8833

Other identifiers 2

IdentifierTypeStateIssuer
300025348MedicaidIN
IN2829OtherINPTAN

Other names 1

  • Journey Road Treatment Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160209001688 IN Part B Supplier - Clinic/Group Practice 1951605161 Receives reassigned benefits from 14 practitioners
Practice locations: Indianapolis, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2112465Acorn Addiction Centers, LLC1201 N Post Rd Suite 4, Indianapolis, IN 46219AccreditationMar 28, 2027

National Provider Directory

National Provider Directory

Locations

1201 N Post Rd
Ste 4
Indianapolis, IN 46219
Phone (317) 405-8833

1515 N Post Rd
Ste 4
Indianapolis, IN 46219

5600 W Bradbury Ave
Indianapolis, IN 46241
Phone (317) 217-1450

5610 Crawfordsville Rd
Ste 1500
Indianapolis, IN 46224
Phone (317) 562-0500

8106 Madison Ave
Indianapolis, IN 46227
Phone (317) 884-1752

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1467824698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N POST ROAD STE. 4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194225",
            "telephone_number": "317-405-8833",
            "fax_number": "317-672-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N POST ROAD STE. 4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194225",
            "telephone_number": "317-405-8833",
            "fax_number": "317-672-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACORN ADDICTION CENTERS LLC DBA JOURNEY ROAD TREATMENT CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "MARI ANNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "317-405-8833"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300025348",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IN2829",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Journey Road Treatment Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Journey Road Treatment Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 17, 2022; 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.