Individual provider Active NPI

Meredith Ann Suttmiller, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1821202136
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005065A Issued in IN
Practice address
4701 N Keystone Ave
Indianapolis, IN 46205-1554
Phone
(317) 205-8317
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005065A IN Primary

Addresses

Primary practice location

4701 N Keystone Ave
Indianapolis, IN 46205-1554

Mailing address

7873 Stonebranch South Dr
Indianapolis, IN 46256-1678
Phone (317) 536-5420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34005065AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821202136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7873 STONEBRANCH SOUTH DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561678",
            "telephone_number": "317-536-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 N KEYSTONE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051554",
            "telephone_number": "317-205-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTMILLER",
        "first_name": "MEREDITH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005065A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.