Individual provider Active NPI

Michael K. McCarthy, CPNP

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1508085218
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71002865A Issued in IN
Practice address
3400 Lafayette Rd
Suite 200
Indianapolis, IN 46222-1146
Phone
(317) 291-7422
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 71002865A IN Primary

Addresses

Primary practice location

3400 Lafayette Rd
Suite 200
Indianapolis, IN 46222-1146

Mailing address

3400 Lafayette Rd
Suite 200
Indianapolis, IN 46222-1146
Phone (317) 291-7422

Other identifiers 1

IdentifierTypeStateIssuer
200858570MedicaidIN

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)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71002865AINMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Clinic-Neurology, LLC Past Accepting new patients
Major Hospital Past Accepting new patients

Organizations & group practices 2

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1508085218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE RD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221146",
            "telephone_number": "317-291-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE RD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221146",
            "telephone_number": "317-291-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "MICHAEL",
        "middle_name": "K.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71002865A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200858570",
            "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 Feb 10, 2015; 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.