Organization Active NPI

Cranial Prosthesis Specialist

  • Prosthetic/Orthotic Supplier
  • Indianapolis, IN
National Provider Identifier
1497425912
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
CRANIAL PROSTHESIS SPECIALIST
Practice address
5126 N Franklin Rd
Indianapolis, IN 46226-2050
Phone
(317) 556-3923
NPI assigned
Sep 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Authorized official

Name
Ghymina Long
Title
Owner
Phone
(317) 556-3923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

5126 N Franklin Rd
Indianapolis, IN 46226-2050

Mailing address

5625 N German Church Rd # 3049
Indianapolis, IN 46235-8513
Phone (833) 633-9447

National Provider Directory

National Provider Directory

Locations

5126 N Franklin Rd
Indianapolis, IN 46226
Phone (317) 556-3923

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1497425912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 N GERMAN CHURCH RD # 3049",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462358513",
            "telephone_number": "833-633-9447",
            "fax_number": "833-633-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 N FRANKLIN RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462262050",
            "telephone_number": "317-556-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANIAL PROSTHESIS SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "GHYMINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-556-3923"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "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 Sep 16, 2021; 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.