Individual provider Active NPI

Radcliffe J V Ganda

  • Adult Companion
  • Indianapolis, IN
National Provider Identifier
1720824014
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
4245 Lafayette Rd
Indianapolis, IN 46254-2409
Phone
(463) 248-5072
NPI assigned
Jul 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X IN
Social Worker 104100000X IN
Behavior Technician 106S00000X IN
Adult Companion 372600000X IN Primary
Case Manager/Care Coordinator 171M00000X IN
Driver 172A00000X IN
Chore Provider 372500000X IN
Home Health Aide 374U00000X IN

Addresses

Primary practice location

4245 Lafayette Rd
Indianapolis, IN 46254-2409

Mailing address

4245 Lafayette Rd
Indianapolis, IN 46254-2409
Phone (463) 248-5072

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ganda Service LLC CurrentSince Sep 23, 2024 Accepting new patients
Victor Investment Alliance LLC CurrentSince Jul 7, 2024 Accepting new patients

Locations

4245 Lafayette Rd
Indianapolis, IN 46254
Phone (463) 248-5072

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1720824014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542409",
            "telephone_number": "463-248-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542409",
            "telephone_number": "463-248-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDA",
        "first_name": "RADCLIFFE",
        "middle_name": "J V",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 5, 2024; 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.