NPIMap

Organization Active NPI

Franciscan Health Indianapolis & Mooresville

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1548458409
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE
Practice address
5230A East Stop 11 Road
Suite 250
Indianapolis, IN 46237-6399
Phone
(317) 528-8921
Fax
(317) 528-6916
NPI assigned
Oct 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Authorized official

Name
Donna Phalen
Title
Director, Abp
Phone
(219) 554-4548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5230A East Stop 11 Road
Suite 250
Indianapolis, IN 46237-6399

Mailing address

PO Box 781008
Detroit, MI 48278-1008
Phone (317) 528-4800

Other identifiers 2

IdentifierTypeStateIssuer
100057420MedicaidIN
100057420AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041201000954 IN Part B Supplier - Clinic/Group Practice 0547154130 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Avon, IN; Franklin, IN; Indianapolis, IN

National Provider Directory

National Provider Directory
Tax ID family
St Francis Behavioral Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 2

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

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1548458409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781008",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781008",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230A EAST STOP 11 ROAD",
            "address_2": "SUITE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462376399",
            "telephone_number": "317-528-8921",
            "fax_number": "317-528-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN HEALTH INDIANAPOLIS & MOORESVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "PHALEN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "DIRECTOR, ABP",
        "authorized_official_telephone_number": "219-554-4548"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100057420",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100057420A",
            "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 13, 2023; 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.