NPIMap

The Damien Center Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Indianapolis, IN

NPI 1821172248 · NPPES record last updated Aug 19, 2025

Key facts

NPI
1821172248
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
THE DAMIEN CENTER INC
Practice address
1420 E Washington St
Indianapolis, IN 46201-3808
Phone
(317) 632-0123
NPI assigned
Oct 24, 2006
Organization subpart
No

Authorized official

Name
Joshua Bundy
Title
Director
Phone
(317) 632-0123

Other NPIs with the same Medicare PAC ID 1

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners 21

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D1013598Damien Center Inc
1420 E Washington St, Indianapolis, IN 46201		Certificate of waiverJun 11, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IN

Federally qualified health center certification: CCN C51054

Legal name
THE DAMIEN CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 11, 2024
Last certification
Sep 11, 2024
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
1420 E Washington St
Indianapolis, IN 46201-2808

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Teresa Driskell
Individual 		W-2 Managing Employee
Chief Clinical Officer		 Jan 8, 2024
Joshua Bundy
Individual 		W-2 Managing Employee
Director		 May 20, 2019
Douglas Huntsinger
Individual 		Corporate Officer
Board Secretary		 Aug 7, 2024
Alan Witchey
Individual 		Corporate Officer Aug 1, 2018
Dawnna Hixon
Individual 		W-2 Managing Employee
Chief Financial Officer		 Nov 28, 2022
Bluehub Loan Fund, Inc.
Organization · Roxbury, MA
Corporation, Non-profit 		5% Or Greater Mortgage Interest Aug 7, 2024
Low Income Investment Fund
Organization · San Francisco, CA
Corporation, Non-profit 		5% Or Greater Mortgage Interest Aug 7, 2024
Reinvestment Fund, Inc.
Organization · Philadelphia, PA
Corporation, Non-profit 		5% Or Greater Mortgage Interest Aug 7, 2024
Jason Dudich
Individual 		Corporate Officer
Board President		 Aug 7, 2024
Esther Carter-Day
Individual 		Corporate Officer
Board Vice President		 Aug 7, 2024
Jeffrey Chapman
Individual 		Corporate Officer
Board Treasurer		 Aug 7, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200608002184 IN Part B Supplier - Clinic/Group Practice 1052732666 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
Practice locations: Indianapolis, IN
O20240913000541 IN Part a Provider - Federally Qualified Health Center (FQHC) 1052732666 Practice locations: Indianapolis, IN

National Provider Directory

Locations

1420 E Washington St
Indianapolis, IN 46201
Phone (317) 632-0123

26 N Arsenal Ave
Ste 1
Indianapolis, IN 46201

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

1420 E Washington St
Indianapolis, IN 46201-3808

Mailing address

26 N Arsenal Ave
Indianapolis, IN 46201-3808
Phone (317) 632-0123

Other practice location 1

26 N Arsenal Ave
Indianapolis, IN 46201-3808
Phone (317) 632-0123

Other identifiers

IdentifierTypeStateIssuer
300040883MedicaidIN

Other names

  • Damien Center Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 19, 2025.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1821172248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 N ARSENAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462013808",
            "telephone_number": "317-632-0123",
            "fax_number": "317-632-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462013808",
            "telephone_number": "317-632-0123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 N Arsenal Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462013808",
            "country_code": "US",
            "telephone_number": "317-632-0123",
            "fax_number": "317-632-4362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE DAMIEN CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "BUNDY",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "317-632-0123"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300040883",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Damien Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Damien Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Federally Qualified Health Center (FQHC) in Indiana

Sources for this page

Verify at the official NPI Registry.