NPIMap

Organization Active NPI

Biorestore LLC

  • Family Medicine Physician
  • Fishers, IN
National Provider Identifier
1801388558
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01068656A Issued in IN
Legal business name
BIORESTORE LLC
Practice address
10967 Allisonville Rd Ste 220
Fishers, IN 46038
Phone
(317) 578-1220
Fax
(833) 228-1102
NPI assigned
May 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Authorized official

Name
Scott G Marsteller, M.D.NPI 1891714937
Title
Owner
Phone
(317) 578-1220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01068656A IN Primary

Addresses

Primary practice location

10967 Allisonville Rd Ste 220
Fishers, IN 46038

Mailing address

914 Ranch Rd
Connersville, IN 47331-1238
Phone (317) 578-1220

National Provider Directory

National Provider Directory

Locations

10967 Allisonville Rd
Ste 220
Fishers, IN 46038
Phone (317) 288-7420

Practitioners & affiliated clinicians

Practitioners 1

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": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1801388558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 RANCH RD",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311238",
            "telephone_number": "317-578-1220",
            "fax_number": "833-228-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10967 ALLISONVILLE RD STE 220",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "46038",
            "telephone_number": "317-578-1220",
            "fax_number": "833-228-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIORESTORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "MARSTELLER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-578-1220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01068656A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.