Active NPI
Celestine Detrana, M.D.
- Psychiatry Physician
- Indianapolis, IN
National Provider Identifier
1750420279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01040560
- Practice address
- 4220 Roland Rd
Indianapolis, IN 46228-3237 - Phone
- (317) 299-8072
- Fax
- (317) 299-8073
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01040560 | IN | Primary |
Addresses
Primary practice location
4220 Roland Rd
Indianapolis, IN 46228-3237
Mailing address
PO Box 88898
Indianapolis, IN 46208-0898
Phone (317) 299-8072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170119002486 | IN | Order and Referring Only - Psychiatry | 9739160292 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040560 | IN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207267200000",
"number": "1750420279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 88898",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462080898",
"telephone_number": "317-299-8072",
"fax_number": "317-299-8073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 ROLAND RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462283237",
"telephone_number": "317-299-8072",
"fax_number": "317-299-8073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETRANA",
"first_name": "CELESTINE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01040560",
"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 Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.