Individual provider Active NPI

Mignon R Holder

  • In Home Supportive Care Agency
  • Indianapolis, IN
National Provider Identifier
1487424644
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
014998 Issued in IN
Practice address
6801 Lake Plaza Dr Ste B214
Indianapolis, IN 46220-4068
Phone
(131) 771-2636
Fax
(317) 827-1030
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 014998 IN Primary

Addresses

Primary practice location

6801 Lake Plaza Dr Ste B214
Indianapolis, IN 46220-4068

Mailing address

6801 Lake Plaza Dr Ste B214
Indianapolis, IN 46220-4068
Phone (131) 771-2636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014998INMDIn Home Supportive Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Altruistic Home Care In Home Supportive Care CurrentSince Apr 9, 2024 Accepting new patients
Benevolent Care Home Health Services LLC Current Accepting new patients
Altruistic Home Health Services LLC CurrentSince Jul 28, 2024 Accepting new patients

Locations

6801 Lake Plaza Dr
Ste B214
Indianapolis, IN 46220
Phone (317) 516-1030

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1487424644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LAKE PLAZA DR STE B214",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204068",
            "telephone_number": "131-771-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LAKE PLAZA DR STE B214",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204068",
            "telephone_number": "131-771-2636",
            "fax_number": "317-827-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "MIGNON",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IN",
            "license": "014998",
            "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 Jan 24, 2024; 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.