Organization Active NPI

In Home Neurodiagnostics LLC

  • Physiological Laboratory
  • Indianapolis, IN
National Provider Identifier
1669719944
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
IN HOME NEURODIAGNOSTICS LLC
Practice address
6230 N Meridian St
Indianapolis, IN 46260-4226
Phone
(317) 333-7390
Fax
(866) 859-7105
NPI assigned
Jan 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Christopher L Driscoll, MA,REEGT, REPT
Title
Member
Phone
(317) 513-5070

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EEG Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0500X 4895 IN
Physiological Laboratory 293D00000X Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

6230 N Meridian St
Indianapolis, IN 46260-4226

Mailing address

6230 N Meridian St
Indianapolis, IN 46260-4226
Phone (317) 333-7390

Other identifiers 1

IdentifierTypeStateIssuer
201181650AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130522000224 IN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2264670744 Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

20 N Home Ave
Franklin, IN 46131
Phone (317) 739-3386

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1669719944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462604226",
            "telephone_number": "317-333-7390",
            "fax_number": "866-859-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462604226",
            "telephone_number": "317-333-7390",
            "fax_number": "866-859-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME NEURODIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "DRISCOLL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-513-5070",
        "authorized_official_credential": "MA,REEGT, REPT"
    },
    "taxonomies": [
        {
            "code": "246ZE0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": "IN",
            "license": "4895",
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201181650A",
            "state": "IN"
        }
    ],
    "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 Oct 14, 2024; 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.