NPIMap

Organization Active NPI

Indiana Internal Medicine Consultants, LLC.

  • Internal Medicine Physician
  • Greenwood, IN
National Provider Identifier
1609834357
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50000962A Issued in IN
Legal business name
INDIANA INTERNAL MEDICINE CONSULTANTS, LLC.
Practice address
701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070
Phone
(317) 885-2860
Fax
(317) 885-2869
NPI assigned
May 3, 2006
Last updated
Sep 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Steven M Samuels, MDNPI 1205806387
Title
Executive Board Secretary
Phone
(317) 885-2860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50000962A IN
Geriatric Medicine (Family Medicine) Physician 207QG0300X 50000962A IN
Internal Medicine Physician 207R00000X 50000962A IN Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 50000962A IN
Infectious Disease Physician 207RI0200X 50000962A IN
Pulmonary Disease Physician 207RP1001X 50000962A IN
Rheumatology Physician 207RR0500X 50000962A IN
Obstetrics & Gynecology Physician 207V00000X 50000962A IN
Pediatrics Physician 208000000X 50000962A
Hospitalist Physician 208M00000X 50000962A IN
Acute Care Nurse Practitioner 363LA2100X 50000962A IN
Adult Health Nurse Practitioner 363LA2200X 50000962A IN
Family Nurse Practitioner 363LF0000X 50000962A IN
Sleep Medicine (Internal Medicine) Physician 207RS0012X 50000962A IN
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 50000962A IN

Addresses

Primary practice location

701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070

Mailing address

701 E County Line Road
Suite 101
Greenwood, IN 46143-1070
Phone (317) 885-2860

Other practice location 1

355 Westfield Rd Ste 114
Noblesville, IN 46060-1442
Phone (317) 770-2937

Other identifiers 1

IdentifierTypeStateIssuer
100058190MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct.indianainternalmedicine@ccme.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329000685 IN Part B Supplier - Clinic/Group Practice 7911899489 Receives reassigned benefits from 116 practitioners
Practice locations: Greenwood, IN

National Provider Directory

National Provider Directory
Tax ID family
Indiana Internal Medicine Consultants LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

701 E County Line Rd
Greenwood, IN 46143
Phone (317) 885-2860

6957 Hillsdale Ct
Slp Diagnostics
Indianapolis, IN 46250
Phone (317) 585-9137

Practitioners & affiliated clinicians

Practitioners 117

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.

View all 117

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1609834357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE ROAD",
            "address_2": "SUITE 101",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431070",
            "telephone_number": "317-885-2860",
            "fax_number": "317-885-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE RD",
            "address_2": "SUITE 101",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431070",
            "telephone_number": "317-885-2860",
            "fax_number": "317-885-2869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Westfield Rd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460601442",
            "country_code": "US",
            "telephone_number": "317-770-2937",
            "fax_number": "317-770-2938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDIANA INTERNAL MEDICINE CONSULTANTS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE BOARD SECRETARY",
        "authorized_official_telephone_number": "317-885-2860",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "50000962A",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IN",
            "license": "50000962A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100058190",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct.indianainternalmedicine@ccme.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 E County Line Rd Ste 101",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.