NPIMap

Organization Active NPI

Development Academy Corporation

Doing business as The Sergeant's Fish & Donut

  • Peer Specialist
  • Indianapolis, IN
National Provider Identifier
1558142430
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
DEVELOPMENT ACADEMY CORPORATION
Doing business as
The Sergeant's Fish & Donut
Practice address
1732 Bellefontaine St Apt 4
Indianapolis, IN 46202-1813
Phone
(317) 503-5254
NPI assigned
Oct 9, 2023
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Paul Collins
Title
Advisor
Phone
(317) 503-5254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

1732 Bellefontaine St Apt 4
Indianapolis, IN 46202-1813

Mailing address

2414 Arthur St
Jeffersonville, IN 47130-9577
Phone (502) 910-1117

Other identifiers 1

IdentifierTypeStateIssuer
1689454126OtherNPI

Other names 1

  • THE SERGEANT'S FISH & DONUT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Development Academy Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1558142430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 ARTHUR ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471309577",
            "telephone_number": "502-910-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 BELLEFONTAINE ST APT 4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021813",
            "telephone_number": "317-503-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENT ACADEMY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-07",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "ADVISOR",
        "authorized_official_telephone_number": "317-503-5254"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689454126",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SERGEANT'S FISH & DONUT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 9, 2023; 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.