Cornerstone Family Physicians, P. C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01049047A Issued in IN

Legal business name

CORNERSTONE FAMILY PHYSICIANS, P. C.

Practice address

8902 N Meridian St
Suite 230
Indianapolis, IN 46260-5382

Phone

(317) 581-8888

Fax

(317) 705-7179

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Shelly Renae Sturgis, BSW

Title

Supervisor

Phone

(317) 581-8888

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jackie L Evans, MD

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1588657860

  Family Medicine, IN

  Medicare reassignment NPD
• Theresa M Krueger, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1427195486

  Family Medicine, IN

  Medicare reassignment NPD
• Emily M Glass, PA-C

  • Physician Assistant
  • Indianapolis, IN
  • NPI 1750799870
  NPD
• Donna Marie Blake, N.P.-C.

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1821429481
  NPD (past)
• Jennifer Anne Low, PA-C

  • Physician Assistant
  • Indianapolis, IN
  • NPI 1225316136
  NPD (past)
• Bridget Stephens Leclair, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1508154774
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1770565830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8902 N MERIDIAN ST",
            "address_2": "SUITE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605382",
            "telephone_number": "317-581-8888",
            "fax_number": "317-705-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8902 N MERIDIAN ST",
            "address_2": "SUITE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605382",
            "telephone_number": "317-581-8888",
            "fax_number": "317-705-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY PHYSICIANS, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "STURGIS",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "RENAE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "317-581-8888",
        "authorized_official_credential": "BSW"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01049047A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200379470A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Associates, LLC
• Cornerstone Caregiving East LLC
• Cornerstone Diabetes and Medical Supplies, LLC
• Cornerstone Distribution LLC
• Cornerstone Family Dentistry
• Cornerstone Healthcare Management Company LLC
• Cornerstone Medical Services- Midwest LLC
• Cornerstone of Indianapolis, LLC
• Cornerstone Support Services, LLC
• Tianna Cornett Sims

• All providers in Indianapolis, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.