NPIMap

Organization Active NPI

Indianapolis Neurosurgical Group

  • Physical Medicine & Rehabilitation Physician
  • Indianapolis, IN
National Provider Identifier
1679733166
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
INDIANAPOLIS NEUROSURGICAL GROUP
Practice address
355 W 16TH St
Suite 5100
Indianapolis, IN 46202-2207
Phone
(317) 396-1300
Fax
(317) 329-3040
NPI assigned
Jun 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Authorized official

Name
Mr. Derek Cantrell, CPA
Title
Cfo
Phone
(317) 396-1392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

355 W 16TH St
Suite 5100
Indianapolis, IN 46202-2207

Mailing address

8333 Naab Rd
Suite 255
Indianapolis, IN 46260-5924
Phone (317) 396-1300

Other names 1

  • Goodman Campbell Brain and Spine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goodman Campbell Brain and Spine21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

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": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1679733166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD",
            "address_2": "SUITE 255",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605924",
            "telephone_number": "317-396-1300",
            "fax_number": "317-329-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "address_2": "SUITE 5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207",
            "telephone_number": "317-396-1300",
            "fax_number": "317-329-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS NEUROSURGICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-396-1392",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodman Campbell Brain and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 26, 2012; 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.