NPIMap

Organization Active NPI

Aspire Indiana Health Inc.

Doing business as Aspire Indiana Health-DeHaven

  • Federally Qualified Health Center (FQHC)
  • Anderson, IN
National Provider Identifier
1801368188
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ASPIRE INDIANA HEALTH INC.
Doing business as
Aspire Indiana Health-DeHaven
Practice address
2020 Brown St
Anderson, IN 46016-4218
Phone
(317) 574-1254
Fax
(317) 674-0060
NPI assigned
Dec 26, 2018
Last updated
Aug 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Authorized official

Name
Timothy D Crockett
Title
Cfo
Phone
(317) 587-0505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

2020 Brown St
Anderson, IN 46016-4218

Mailing address

697 Pro Med LN
Carmel, IN 46032-5323
Phone (317) 574-1254

Other names 1

  • Aspire Indiana Health-DeHaven Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150902001749 IN Part B Supplier - Clinic/Group Practice 8921314196 Receives reassigned benefits from 203 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, IN; Noblesville, IN; Lebanon, IN; Indianapolis, IN; Carmel, IN; Elwood, IN
O20190111000281 IN Part A Provider - Federally Qualified Health Center (FQHC) 8921314196 Practice locations: Anderson, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801368188. Details of each certification follow.

Federally qualified health center certification: CCN 151030

Legal name
ASPIRE INDIANA HEALTH INC
Doing business as
ASPIRE INDIANA HEALTH -DEHAVEN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 9, 2019
Last certification
Jan 9, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2020 Brown St
Anderson, IN 46016-4218

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Aspire Indiana Health Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2020 Brown St
Anderson, IN 46016
Phone (317) 649-8161

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Timothy Crockett Individual Corporate OfficerChief Financial Officer Aug 1, 2018
W-2 Managing EmployeeChief Financial Officer Aug 1, 2018
Operational/Managerial ControlChief Financial Office Aug 1, 2018

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Anderson Indiana Health - WillowbrookIndianapolis, IN, CCN 151004 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health IncElwood, IN, CCN 151003 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire May HouseAnderson, IN, CCN 151002 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health IncAnderson, IN, CCN 151001 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health - CarmelCarmel, IN, CCN 151008 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health - Boone CountyLebanon, IN, CCN 151014 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 31, 2018
Aspire Indiana Health-NoblesvilleNoblesville, IN, CCN 151017 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2015
Aspire Indiana Health - Progress House MainIndianapolis, IN, CCN 151084 Federally qualified health center 5% Or Greater Direct Ownership Interest Jun 25, 2015

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1801368188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 PRO MED LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325323",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BROWN ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164218",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPIRE INDIANA HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-26",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-587-0505"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspire Indiana Health-DeHaven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.