Indianapolis Neurosurgical Group PC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

INDIANAPOLIS NEUROSURGICAL GROUP PC

Practice address

7120 Clearvista Dr
Suite 3100
Indianapolis, IN 46256-1621

Phone

(317) 396-1300

Fax

(317) 396-1468

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Derek Cantrell

Title

Cfo

Phone

(317) 396-1386

Specialties & licenses 3

Addresses

Other names 1

• Goodman Campbell Brain and Spine Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Indianapolis Neurosurgical Group PC

  • Neurological Surgery Physician
  • Greenwood, IN
  • NPI 1023035482

  O20040324000655

  Same enrollment
• Indianapolis Neurosurgical Group PC

  • Neurological Surgery Physician
  • Carmel, IN
  • NPI 1275580318

  O20040324000655

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derron Wilson, MD

  • Pain Medicine (Anesthesiology) Physician
  • Carmel, IN
  • NPI 1780669267
  NPD

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1528085974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13345 ILLINOIS ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323318",
            "telephone_number": "317-396-1462",
            "fax_number": "317-396-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 CLEARVISTA DR",
            "address_2": "SUITE 3100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561621",
            "telephone_number": "317-396-1300",
            "fax_number": "317-396-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS NEUROSURGICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-396-1386"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodman Campbell Brain and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Indianapolis Neurosurgical Group
• Indianapolis Neurosurgical Group
• Indianapolis Neurosurgical Group
• Indianapolis Neurosurgical Group
• Indianapolis Neurosurgical Group
• Indianapolis Neurosurgical Group PC
• Indianapolis Operating Company LLC
• Indianapolis Operating Company, LLC
• Indianapolis Ophthalmology PC
• Indianapolis Ophthalmology PC

• All providers in Indianapolis, IN
• Neurological Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.