Individual provider Active NPI

Nikita Vijayan

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1710468830
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05012407A Issued in IN
Practice address
7301 E 16TH St
Indianapolis, IN 46219-2308
Phone
(317) 353-1290
NPI assigned
Aug 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05012407A IN Primary

Addresses

Primary practice location

7301 E 16TH St
Indianapolis, IN 46219-2308

Mailing address

12950 Grand Blvd Apt 2K15
Carmel, IN 46032-5290
Phone (909) 665-5661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05012407AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1710468830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12950 GRAND BLVD APT 2K15",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325290",
            "telephone_number": "909-665-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 E 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462192308",
            "telephone_number": "317-353-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYAN",
        "first_name": "NIKITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012407A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 27, 2018; 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.