Individual provider Active NPI

Mia Suzanne Trueblood

  • Student in an Organized Health Care Education/Training Program
  • Greenwood, IN
National Provider Identifier
1619712734
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
702 Greenwood Springs Dr Apt 2416
Greenwood, IN 46143-6064
Phone
(812) 272-3220
NPI assigned
Jun 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

702 Greenwood Springs Dr Apt 2416
Greenwood, IN 46143-6064

Mailing address

702 Greenwood Springs Dr Apt 2416
Greenwood, IN 46143-6064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260627000232 IN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2769955046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1719619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1619712734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 GREENWOOD SPRINGS DR APT 2416",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 GREENWOOD SPRINGS DR APT 2416",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436064",
            "telephone_number": "812-272-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUEBLOOD",
        "first_name": "MIA",
        "middle_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-29",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.