Westside Gynecology, Inc.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

01029614A Issued in IN

Legal business name

WESTSIDE GYNECOLOGY, INC.

Practice address

6920 Parkdale PL
Suite 100
Indianapolis, IN 46254-5612

Phone

(317) 329-7177

Fax

(317) 329-7180

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Josue J Villalta, MD

Title

President

Phone

(317) 329-7177

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487741377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 PARKDALE PL",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545612",
            "telephone_number": "317-329-7177",
            "fax_number": "317-329-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 PARKDALE PL",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545612",
            "telephone_number": "317-329-7177",
            "fax_number": "317-329-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE GYNECOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VILLALTA",
        "authorized_official_first_name": "JOSUE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-329-7177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IN",
            "license": "01029614A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NUMBER",
            "identifier": "000000093399",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.