NPIMap

Organization Active NPI

Gary L Llewellyn DDS LLC

  • Customized Equipment (DME)
  • Indianapolis, IN
National Provider Identifier
1477979300
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
12008920 Issued in IN
Legal business name
GARY L LLEWELLYN DDS LLC
Practice address
6211 W 30TH St
G
Indianapolis, IN 46224-3048
Phone
(317) 291-7550
Fax
(317) 291-1746
NPI assigned
Mar 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Authorized official

Name
Gary L Llewellyn, DDSNPI 1780800771
Title
Owner
Phone
(317) 291-7550

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
Customized Equipment (DME) 332BC3200X 12008920 IN Primary

Addresses

Primary practice location

6211 W 30TH St
G
Indianapolis, IN 46224-3048

Mailing address

6211 W 30TH St Ste G
Indianapolis, IN 46224-3057
Phone (317) 291-7550

Other identifiers 1

IdentifierTypeStateIssuer
12008920OtherINDDS

National Provider Directory

National Provider Directory

Locations

6211 W 30th St
Ste G
Speedway, IN 46224
Phone (317) 291-7550

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1477979300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 W 30TH ST STE G",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243057",
            "telephone_number": "317-291-7550",
            "fax_number": "317-291-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 W 30TH ST",
            "address_2": "G",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243048",
            "telephone_number": "317-291-7550",
            "fax_number": "317-291-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY L LLEWELLYN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "LLEWELLYN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-291-7550",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IN",
            "license": "12008920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DDS",
            "identifier": "12008920",
            "state": "IN"
        }
    ],
    "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 Apr 23, 2014; 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.