Individual provider Active NPI

Danielle M Erney, MD

  • Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1568690519
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01071410A Issued in IN
Practice address
2625 E 62ND St
Ste 2010
Indianapolis, IN 46220-3189
Phone
(317) 251-6121
Fax
(317) 257-0390
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01071410A IN Primary

Addresses

Primary practice location

2625 E 62ND St
Ste 2010
Indianapolis, IN 46220-3189

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
201085470MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address derney@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627000427 IN Practitioner - Pediatric Medicine 7113142548 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01071410AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Aug 1, 2014 Accepting new patients
University Family Physicians, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Aug 6, 2021 Accepting new patients
Carmel Pediatrics, LLC Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

2625 E 62nd St
Ste 2010
Indianapolis, IN 46220
Phone (317) 251-6121

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

9650 E Washington St
Ste 245
Indianapolis, IN 46229
Phone (317) 890-5552

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

Interoperability endpoints

  • Direct secure messaging: derney@direct.iuhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1568690519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 E 62ND ST",
            "address_2": "STE 2010",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203189",
            "telephone_number": "317-251-6121",
            "fax_number": "317-257-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNEY",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01071410A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201085470",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "derney@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2625 E 62nd St",
            "address_2": "Ste 2010",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462203189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.