NPIMap

Organization Active NPI

Indy Medical Trans LLC

  • Non-emergency Medical Transport (VAN)
  • Indianapolis, IN
National Provider Identifier
1568062511
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
INDY MEDICAL TRANS LLC
Practice address
4948 W Washington St
Indianapolis, IN 46241
Phone
(317) 381-1111
NPI assigned
Oct 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Mekonnen Gerezgher
Title
Manager
Phone
(317) 381-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

4948 W Washington St
Indianapolis, IN 46241

Mailing address

4948 W Washington St
Indianapolis, IN 46241
Phone (317) 381-1111

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1568062511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 W WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46241",
            "telephone_number": "317-381-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4948 W WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46241",
            "telephone_number": "317-381-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY MEDICAL TRANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "GEREZGHER",
        "authorized_official_first_name": "MEKONNEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "317-381-1111"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "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 Oct 29, 2020; 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.