Active NPI
Carrie B. Boyd Healthcare Center
- Health Service Clinic/Center
- Indianapolis, IN
National Provider Identifier
1609323708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- 02003708A
- Legal business name
- CARRIE B. BOYD HEALTHCARE CENTER
- Practice address
- 5555 N Tacoma Ave
12
Indianapolis, IN 46220-3512 - Phone
- (317) 501-0210
- NPI assigned
- Sep 6, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Carla V Cork, D.O., M.A.T.
- Title
- Physician/Owner
- Phone
- (317) 501-0210
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | 02003708A | IN | Primary |
Addresses
Primary practice location
5555 N Tacoma Ave
12
Indianapolis, IN 46220-3512
Mailing address
PO Box 7140
Fishers, IN 46038-7140
Phone (317) 501-0210
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://api.platform.athenahealth.com/12519/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1473120000000",
"number": "1609323708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7140",
"city": "FISHERS",
"state": "IN",
"postal_code": "460387140",
"telephone_number": "317-501-0210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 N TACOMA AVE",
"address_2": "12",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462203512",
"telephone_number": "317-501-0210"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARRIE B. BOYD HEALTHCARE CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2016-09-06",
"last_updated": "2016-09-06",
"status": "A",
"authorized_official_last_name": "CORK",
"authorized_official_first_name": "CARLA",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "317-501-0210",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O., M.A.T."
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "IN",
"license": "02003708A",
"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 Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.