NPIMap

Organization Active NPI

Aspire Indiana Health Inc.

Doing business as Aspire Indiana Health - Mockingbird Hill

  • Federally Qualified Health Center (FQHC)
  • Anderson, IN
National Provider Identifier
1700476306
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ASPIRE INDIANA HEALTH INC.
Doing business as
Aspire Indiana Health - Mockingbird Hill
Practice address
4038 Ridgeview Dr Ste 1
Anderson, IN 46013-9715
Phone
(317) 574-1254
Fax
(317) 674-0060
NPI assigned
Jan 19, 2021
Last updated
Aug 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Authorized official

Name
Timothy D Crockett
Title
Cfo
Phone
(317) 587-0505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

4038 Ridgeview Dr Ste 1
Anderson, IN 46013-9715

Mailing address

697 Pro Med LN
Carmel, IN 46032-5323
Phone (317) 574-1254

Other names 1

  • Aspire Indiana Health - Mockingbird Hill Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150902001749 IN Part B Supplier - Clinic/Group Practice 8921314196 Receives reassigned benefits from 203 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, IN; Noblesville, IN; Lebanon, IN; Indianapolis, IN; Carmel, IN; Elwood, IN
O20210128000507 IN Part A Provider - Federally Qualified Health Center (FQHC) 8921314196 Practice locations: Anderson, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700476306. Details of each certification follow.

Federally qualified health center certification: CCN 151095

Legal name
ASPIRE INDIANA HEALTH INC
Doing business as
ASPIRE INDIANA HEALTH-MOCKINGBIRD HILL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 29, 2021
Last certification
Jan 29, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4038 Ridgeview Dr
Ste 1
Anderson, IN 46013-9715

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Member organizations 1

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

Locations

4038 Ridgeview Dr
#1
Anderson, IN 46013
Phone (317) 587-0533

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Carolyn Barr Individual Corporate DirectorBoard Member Aug 1, 2015
Kevin Martin Individual Corporate DirectorBoard Member Jan 1, 2026
Michael Collette Individual Corporate DirectorBoard Member Aug 1, 2018
Vincent Smith Individual Corporate DirectorBoard Member Jan 1, 2026
Timothy Crockett Individual Corporate OfficerChief Financial Officer Aug 1, 2018
W-2 Managing EmployeeChief Financial Officer Aug 1, 2018
Operational/Managerial ControlChief Financial Officer Aug 1, 2018
Mike Thibideau Individual Corporate DirectorBoard Member Jan 1, 2026
Lee Cannon Individual Corporate DirectorSecretary Jan 1, 2026
Steve Wormhoff Individual Corporate DirectorBoard Member Jan 1, 2026
Trent Scott Individual Corporate DirectorBoard Member Aug 1, 2014
Jody Horstman Individual Corporate OfficerCoo Dec 13, 2018
W-2 Managing EmployeeCoo Dec 13, 2018
Operational/Managerial ControlCoo Dec 13, 2018
Leroy Quashie Individual Corporate DirectorBoard Member Jul 1, 2010
Ted Sherfick Individual Corporate DirectorBoard Member Aug 1, 2019
James Skeel Individual Corporate OfficerChief Quality Officer Aug 12, 2019
Corporate DirectorChief Quality Officer Aug 12, 2019
Jeffrey L Reed Individual Corporate DirectorBoard Member Aug 1, 2000
Duane Hoak Individual Corporate DirectorBoard Member Jul 1, 2010
Obadiah Smith Individual Corporate DirectorBoard Member Aug 1, 2015
Eric a Marcotte Individual Corporate DirectorBoard Member Aug 1, 2019
Rob Spaulding Individual Corporate DirectorBoard Member Aug 1, 2017
Antony Sheehan Individual Corporate OfficerCeo/President Sep 5, 2023
W-2 Managing EmployeeCeo/President Sep 5, 2023
Operational/Managerial ControlCeo/President Sep 5, 2023
Celeste Evers Individual Corporate DirectorBoard Member Jan 1, 2026

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Anderson Indiana Health - WillowbrookIndianapolis, IN, CCN 151004 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health IncElwood, IN, CCN 151003 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire May HouseAnderson, IN, CCN 151002 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health IncAnderson, IN, CCN 151001 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health - CarmelCarmel, IN, CCN 151008 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health - Boone CountyLebanon, IN, CCN 151014 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 31, 2018
Aspire Indiana Health-NoblesvilleNoblesville, IN, CCN 151017 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health - Progress House MainIndianapolis, IN, CCN 151084 Federally qualified health center 5% Or Greater Direct Ownership Interest Jun 25, 2015

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1700476306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 PRO MED LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325323",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4038 RIDGEVIEW DR STE 1",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460139715",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPIRE INDIANA HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-587-0505"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspire Indiana Health - Mockingbird Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.