Indy Spine & Joint LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INDY SPINE & JOINT LLC

Practice address

6865 Parkdale PL Ste C
Indianapolis, IN 46254-5655

Phone

(317) 388-4023

Fax

(317) 610-0716

NPI assigned

Sep 6, 2023

Organization subpart

No

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

Authorized official

Name

Brandon Coleman

Title

Owner

Phone

(317) 503-6329

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1760268601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 PARKDALE PL STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6865 PARKDALE PL STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545655",
            "telephone_number": "317-388-4023",
            "fax_number": "317-610-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY SPINE & JOINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-503-6329"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.