Organization Active NPI

Central Indiana Allergy LLC

  • Allergy Physician
  • Greenwood, IN
National Provider Identifier
1801027099
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
CENTRAL INDIANA ALLERGY LLC
Practice address
965 Emerson Pkwy Ste B
Greenwood, IN 46143-6274
Phone
(317) 865-0055
Fax
(317) 865-0056
NPI assigned
Aug 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Mrs. Angela Ray
Title
Manager
Phone
(317) 865-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207KA0200X Primary

Addresses

Primary practice location

965 Emerson Pkwy Ste B
Greenwood, IN 46143-6274

Mailing address

965 Emerson Pkwy Ste B
Greenwood, IN 46143-6274
Phone (317) 865-0055

Other practice location 1

902 N Samuel Moore Pkwy
Mooresville, IN 46158-1475
Phone (317) 865-0055

Other identifiers 1

IdentifierTypeStateIssuer
200917240MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address msmith@ciallergy.com Direct
Direct Messaging Address pm@ciallergy.com Direct

National Provider Directory

National Provider Directory

Locations

965 Emerson Pkwy
Ste B
Greenwood, IN 46143
Phone (317) 865-0055

Practitioners & affiliated clinicians

Practitioners 2

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": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1801027099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 EMERSON PKWY STE B",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436274",
            "telephone_number": "317-865-0055",
            "fax_number": "317-865-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 EMERSON PKWY STE B",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436274",
            "telephone_number": "317-865-0055",
            "fax_number": "317-865-0056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 N Samuel Moore Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "IN",
            "postal_code": "461581475",
            "country_code": "US",
            "telephone_number": "317-865-0055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL INDIANA ALLERGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "317-865-0055",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200917240",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msmith@ciallergy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "965 Emerson Pkwy Ste B",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461436274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pm@ciallergy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "965 Emerson Pkwy Ste B",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461436274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.