NPIMap

Organization Active NPI

Indiana Spine Group, PC

  • Pain Medicine (Anesthesiology) Physician
  • Greenwood, IN
National Provider Identifier
1508220633
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
50004386A Issued in IN
Legal business name
INDIANA SPINE GROUP, PC
Practice address
747 E. County Line Rd.
Suite L
Greenwood, IN 46143-1082
Phone
(317) 893-1960
Fax
(317) 851-9728
NPI assigned
Apr 5, 2016
Last updated
Apr 5, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
INDIANA SPINE GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Authorized official

Name
Hardeep Sikand
Title
Ceo
Phone
(317) 228-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 50004386A IN Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X 50004386A IN

Addresses

Primary practice location

747 E. County Line Rd.
Suite L
Greenwood, IN 46143-1082

Mailing address

13225 N Meridian St
Carmel, IN 46032-5480
Phone (317) 228-7000

Other identifiers 2

IdentifierTypeStateIssuer
200359410MedicaidIN
000000214063OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308001261 IN Part B Supplier - Clinic/Group Practice 4082502349 Receives reassigned benefits from 52 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomington, IN; Anderson, IN; Zionsville, IN; Westfield, IN; West Lafayette, IN; Vincennes, IN; Terre Haute, IN; Shelbyville, IN…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Indiana Spine Group PC4 organizations share this tax ID, including this one
Part of
Indiana Spine Group PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1508220633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13225 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325480",
            "telephone_number": "317-228-7000",
            "fax_number": "317-228-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 E. COUNTY LINE RD.",
            "address_2": "SUITE L",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431082",
            "telephone_number": "317-893-1960",
            "fax_number": "317-851-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA SPINE GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIANA SPINE GROUP, PC",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "SIKAND",
        "authorized_official_first_name": "HARDEEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-228-7000"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "50004386A",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IN",
            "license": "50004386A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200359410",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000214063",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.