NPIMap

Organization Active NPI

Indiana University Medical Genetics Service, Inc.

  • Clinical Cytogenetics Physician
  • Indianapolis, IN
National Provider Identifier
1780637058
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cytogenetics PhysicianTaxonomy code 207SC0300X
Legal business name
INDIANA UNIVERSITY MEDICAL GENETICS SERVICE, INC.
Practice address
975 W Walnut St
Indianapolis, IN 46202-5181
Phone
(317) 274-2966
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Authorized official

Name
Dr. Bryan E Hainline, MD, PHD
Title
Physician
Phone
(317) 274-2966

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cytogenetics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207SC0300X IN Primary
Clinical Genetics (M.D.) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207SG0201X IN
Clinical Molecular Genetics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207SG0203X IN
Molecular Genetic Pathology (Medical Genetics) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207SM0001X IN

Addresses

Primary practice location

975 W Walnut St
Indianapolis, IN 46202-5181

Mailing address

250 N Shadeland Ave
Suite 130
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
100460350MedicaidIN

National Provider Directory

National Provider Directory

Locations

3700 Bellemeade Ave
Ste 109
Evansville, IN 47714
Phone (812) 485-7772

975 W Walnut St
Indianapolis, IN 46202
Phone (317) 274-2241

975 W Walnut St
#130
Indianapolis, IN 46202
Phone (317) 274-2241

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1780637058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "SUITE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 W WALNUT ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025181",
            "telephone_number": "317-274-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY MEDICAL GENETICS SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "HAINLINE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "317-274-2966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207SC0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207SG0203X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Medical Genetics, Clinical Molecular Genetics",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207SM0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Medical Genetics, Molecular Genetic Pathology",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100460350",
            "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, 2014; 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.