Individual provider Active NPI

Maria A St. Clair

  • Contractor
  • Indianapolis, IN
National Provider Identifier
1508349648
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
49-491420 Issued in IN
Practice address
5506 Dollar Hide South Dr
Indianapolis, IN 46221-4113
Phone
(317) 830-6264
NPI assigned
Sep 14, 2018
Last updated
Sep 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193200000X MULTI-SPECIALTY GROUP 171W00000X 49-491420 IN Primary

Addresses

Primary practice location

5506 Dollar Hide South Dr
Indianapolis, IN 46221-4113

Mailing address

5506 Dollar Hide South Dr
Indianapolis, IN 46221-4113
Phone (317) 830-6264

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
49-491420INMDContractor

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1508349648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 DOLLAR HIDE SOUTH DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462214113",
            "telephone_number": "317-830-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5506 DOLLAR HIDE SOUTH DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462214113",
            "telephone_number": "317-830-6264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. CLAIR",
        "first_name": "MARIA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "IN",
            "license": "49-491420",
            "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 14, 2018; 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.