NPIMap

Organization Active NPI

St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1669422234
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-2273
NPI assigned
May 12, 2006
Last updated
Oct 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Brian Morris
Title
Cfo (SVMG)
Phone
(317) 338-6234

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Clinical Neuropsychologist 103G00000X
Psychologist 103T00000X
Optometrist 152W00000X
Family Medicine Physician 207Q00000X Primary
Sports Medicine (Family Medicine) Physician 207QS0010X
Internal Medicine Physician 207R00000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Sports Medicine (Internal Medicine) Physician 207RS0010X
Obstetrics & Gynecology Physician 207V00000X
Gynecologic Oncology Physician 207VX0201X
Pediatrics Physician 208000000X
Psychiatry Physician 2084P0800X
Surgery Physician 208600000X

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

10330 N Meridian St
Suite 201
Indianapolis, IN 46290-1024

Other identifiers 12

IdentifierTypeStateIssuer
100055800GMedicaidIN
100055800AMedicaidIN
200802910AMedicaidIN
100055800CMedicaidIN
200827600AMedicaidIN
100055800DMedicaidIN
100055800BMedicaidIN
100055800EMedicaidIN
100345550AMedicaidIN
200827600BMedicaidIN
200827600CMedicaidIN
100055800FMedicaidIN

Other names 1

  • ST VINCENT PHYSICIAN SERVICES Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223001092 IN Part B Supplier - Clinic/Group Practice 9638072184 Receives reassigned benefits from 506 practitioners
1 other NPI on this enrollment

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
St Vincent Stress Center

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

309 Medic Way
Greencastle, IN 46135
Phone (765) 301-7200

1001 Broad Ripple Ave
Indianapolis, IN 46220
Phone (317) 259-7777

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

8330 Naab Rd
Ste 340
Indianapolis, IN 46260
Phone (317) 338-5100

8402 Harcourt Rd
#408
Indianapolis, IN 46260
Phone (317) 338-5431

8402 Harcourt Rd
Ste 408
Indianapolis, IN 46260
Phone (317) 338-5431

8414 Naab Rd
Ste 135
Indianapolis, IN 46260
Phone (317) 338-7760

Practitioners & affiliated clinicians

Practitioners 533

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 533

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1669422234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO (SVMG)",
        "authorized_official_telephone_number": "317-338-6234"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055800G",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055800A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200802910A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055800C",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200827600A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055800D",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055800B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055800E",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100345550A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200827600B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200827600C",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055800F",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST VINCENT PHYSICIAN SERVICES",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ST VINCENT PHYSICIAN SERVICES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 7, 2021; 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.