NPIMap

Organization Active NPI

Indiana Polyclinic PC

  • Pain Clinic/Center
  • Carmel, IN
National Provider Identifier
1609117118
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
INDIANA POLYCLINIC PC
Practice address
201 Pennsylvania Pkwy
Suite 200
Carmel, IN 46280
Phone
(317) 805-5500
Fax
(317) 805-5501
NPI assigned
Mar 7, 2013
Last updated
Jul 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Authorized official

Name
Cheryl E Adams
Title
Director of Patient Accounts
Phone
(317) 805-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

201 Pennsylvania Pkwy
Suite 200
Carmel, IN 46280

Mailing address

201 Pennsylvania Pkwy
Suite 200
Carmel, IN 46280
Phone (317) 805-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130709000091 IN Part B Supplier - Clinic/Group Practice 6608016019 Receives reassigned benefits from 11 practitioners
Practice locations: Carmel, IN
O20231012002554 IN DME Supplier - Physician - Interventional Pain Management 6608016019 Practice locations: Carmel, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1609117118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46280",
            "telephone_number": "317-805-5500",
            "fax_number": "317-805-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY",
            "address_2": "SUITE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46280",
            "telephone_number": "317-805-5500",
            "fax_number": "317-805-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA POLYCLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "317-805-5500"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.