NPIMap

Organization Active NPI

St. Vincent Medical Group, Inc.

  • Occupational Medicine Physician
  • Fishers, IN
National Provider Identifier
1700650645
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
ST. VINCENT MEDICAL GROUP, INC.
Doing business as
ASCENSION MEDICAL GROUP ST. VINCENT
Practice address
7199 Easy St
Fishers, IN 46038-2641
Phone
(317) 415-6110
NPI assigned
Nov 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083X0100X Primary

Addresses

Primary practice location

7199 Easy St
Fishers, IN 46038-2641

Mailing address

250 W 96TH St Ste 520
Indianapolis, IN 46260-1317

Other names 2

  • ASCENSION MEDICAL GROUP ST. VINCENT Doing business as
  • WELLNESS - EASY STREET Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0691732Ascension Medical Group St Vincent -7199 Easy Street, Fishers, IN 46038Certificate of waiverJun 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Medical Group Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1700650645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST STE 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7199 EASY ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382641",
            "telephone_number": "317-415-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-338-6234"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASCENSION MEDICAL GROUP ST. VINCENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WELLNESS - EASY STREET",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.