Individual provider Active NPI

Ted Amos, MDIV. LMFT CSAYC

  • Marriage & Family Therapist
  • Indianapolis, IN
National Provider Identifier
1568993269
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35001925 Issued in IN
Practice address
5638 Professional Cir
Indianapolis, IN 46241
Phone
(888) 714-1927
Fax
(317) 247-8935
NPI assigned
Mar 23, 2017
Last updated
May 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 35001925 IN Primary

Addresses

Primary practice location

5638 Professional Cir
Indianapolis, IN 46241

Mailing address

4319 E 56TH St
Indianapolis, IN 46220-5776
Phone (317) 775-7976

Other practice location 1

4319 E 56th St
Indianapolis, IN 46220-5776
Phone (317) 775-7976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35001925INMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cummins Behavioral Health Systems, Incorporated PastSince Apr 9, 2001 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1568993269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 E 56TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462205776",
            "telephone_number": "317-775-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 PROFESSIONAL CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46241",
            "telephone_number": "888-714-1927",
            "fax_number": "317-247-8935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4319 E 56th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462205776",
            "country_code": "US",
            "telephone_number": "317-775-7976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMOS",
        "first_name": "TED",
        "credential": "MDIV. LMFT CSAYC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001925",
            "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 May 31, 2018; 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.