Active NPI
Gary L Dunnington, M.D.
- Surgery Physician
- Indianapolis, IN
National Provider Identifier
1528049871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 01071798A
- Practice address
- 545 Barnhill Dr
Eh 203
Indianapolis, IN 46202-5112 - Phone
- (317) 274-0283
- Fax
- (317) 278-1635
- NPI assigned
- Nov 11, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | 036096459 | IL | |
| Surgery Physician | 208600000X | 01071798A | IN | Primary |
Addresses
Primary practice location
545 Barnhill Dr
Eh 203
Indianapolis, IN 46202-5112
Mailing address
250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000791600 | Other | IN | ANTHEM PIN |
| 036096459 | Medicaid | IL | |
| 201114420 | Medicaid | IN |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036096459 | IL | MD | Surgical Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403136000000",
"number": "1528049871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"address_2": "STE 130 PROVIDER ENROLLMENT",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 BARNHILL DR",
"address_2": "EH 203",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025112",
"telephone_number": "317-274-0283",
"fax_number": "317-278-1635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNNINGTON",
"first_name": "GARY",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-11",
"last_updated": "2014-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "IL",
"license": "036096459",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "01071798A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000791600",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036096459",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201114420",
"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 Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.