NPIMap

Individual provider Active NPI

Charles E.N. Kinsella, M.D.

  • Pulmonary Disease Physician
  • Indianapolis, IN
National Provider Identifier
1740248863
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01041688 Issued in IN
Practice address
6047 Brokenhurst Rd
Indianapolis, IN 46220-4987
Phone
(317) 726-1213
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01041688A IN
Internal Medicine Physician 207R00000X 01041688A IN
Pulmonary Disease Physician 207RP1001X R3M79 MO
Sleep Medicine (Internal Medicine) Physician 207RS0012X 01041688A IN
Pulmonary Disease Physician 207RP1001X 01041688 IN Primary

Addresses

Primary practice location

6047 Brokenhurst Rd
Indianapolis, IN 46220-4987

Mailing address

6047 Brokenhurst Rd
Indianapolis, IN 46220-4987
Phone (317) 726-1213

Other identifiers 4

IdentifierTypeStateIssuer
P00183318OtherINPROVIDER RAILROAD PIN
000000349806OtherINPROVIDER ANTHEM PIN
201764827OtherINPROVIDER CORP PIN
100218260AMedicaidIN

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01041688AINMDInternal Medicine Physician
01041688INMDPulmonary Disease Physician
R3M79MOMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Hospital and Health Centers Past Accepting new patients
Major Hospital Past Accepting new patients

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1740248863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6047 BROKENHURST RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204987",
            "telephone_number": "317-726-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6047 BROKENHURST RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204987",
            "telephone_number": "317-726-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "CHARLES",
        "middle_name": "E.N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01041688A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01041688A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "R3M79",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IN",
            "license": "01041688A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01041688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER RAILROAD PIN",
            "identifier": "P00183318",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ANTHEM PIN",
            "identifier": "000000349806",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER CORP PIN",
            "identifier": "201764827",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100218260A",
            "state": "IN"
        }
    ],
    "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 1, 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.