Individual provider Active NPI

C Keith Chitty, MD

  • Pediatrics Physician
  • Carmel, IN
National Provider Identifier
1609983196
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01057411 Issued in IN
Practice address
12065 Old Meridian St Ste 100
Carmel, IN 46032-8774
Phone
(317) 844-5351
Fax
(317) 844-0310
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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 01057411 IN Primary

Addresses

Primary practice location

12065 Old Meridian St Ste 100
Carmel, IN 46032-8774

Mailing address

12065 Old Meridian St Ste 100
Carmel, IN 46032-8774
Phone (317) 844-5351

Other practice location 1

1701 N Senate Ave
Dept of Pediatrics
Indianapolis, IN 46202-5306
Phone (317) 962-8067

Other identifiers 2

IdentifierTypeStateIssuer
200440340MedicaidIN
206754400MedicaidMO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01057411INMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Pediatrics LLC Past Accepting new patients
Major Hospital Past Accepting new patients

Organizations & group practices 2

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1609983196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12065 OLD MERIDIAN ST STE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328774",
            "telephone_number": "317-844-5351",
            "fax_number": "317-844-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12065 OLD MERIDIAN ST STE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328774",
            "telephone_number": "317-844-5351",
            "fax_number": "317-844-0310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Ave",
            "address_2": "Dept of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025306",
            "country_code": "US",
            "telephone_number": "317-962-8067",
            "fax_number": "317-962-3796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHITTY",
        "first_name": "C KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01057411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200440340",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206754400",
            "state": "MO"
        }
    ],
    "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 Nov 18, 2020; 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.