Qualified Healthcare LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

QUALIFIED HEALTHCARE LLC

Practice address

5555 N Tacoma Ave Ste 104
Indianapolis, IN 46220-3551

Phone

(317) 426-2210

Fax

(317) 779-2560

NPI assigned

Nov 17, 2020

Organization subpart

No

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

Authorized official

Name

Deborah McGlasson, FNP-BC

Title

President

Phone

(317) 426-2210

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1700489390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 N TACOMA AVE STE 104",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203551",
            "telephone_number": "317-426-2210",
            "fax_number": "317-779-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N TACOMA AVE STE 104",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203551",
            "telephone_number": "317-426-2210",
            "fax_number": "317-779-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALIFIED HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "MCGLASSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-426-2210",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.