Individual provider Active NPI

Paul Bradley Fossier, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1750709515
Registry record updated Nov 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11017882A Issued in IN
Practice address
8414 Naab Rd Ste 120
Indianapolis, IN 46260-1972
Phone
(317) 338-7578
Fax
(317) 338-7494
NPI assigned
Mar 30, 2014
Last updated
Nov 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 11017882A IN Primary

Addresses

Primary practice location

8414 Naab Rd Ste 120
Indianapolis, IN 46260-1972

Mailing address

8414 Naab Rd Ste 120
Indianapolis, IN 46260-1972
Phone (317) 338-7578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191018001323 LA Practitioner - Family Practice 7911122726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital Service District of West Feliciana Parish Louisiana Current Accepting new patients
The Hospital Service District of West Feliciana Parish Louisiana Past Accepting new patients

Locations

5266 Commerce St
Bldg A
Saint Francisville, LA 70775
Phone (225) 635-2441

Interoperability endpoints

  • Direct secure messaging: paul.fossier.1@18086.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414886400000",
    "number": "1750709515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 NAAB RD STE 120",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972",
            "telephone_number": "317-338-7578",
            "fax_number": "317-338-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8414 NAAB RD STE 120",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972",
            "telephone_number": "317-338-7578",
            "fax_number": "317-338-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSIER",
        "first_name": "PAUL",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-30",
        "last_updated": "2014-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11017882A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.