NPIMap

Organization Active NPI

Clearvista Recovery Associates PC

  • Addiction Medicine (Internal Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1821281973
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
01028972 Issued in IN
Legal business name
CLEARVISTA RECOVERY ASSOCIATES PC
Practice address
7250 Clearvista Dr
Suite 327a
Indianapolis, IN 46256-4692
Phone
(317) 621-7390
Fax
(317) 621-4494
NPI assigned
Aug 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Authorized official

Name
Mr. Timothy J Kelly, M.D.NPI 1730297748
Title
Owner
Phone
(317) 621-7390

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 01028972 IN
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X 01028972 IN Primary

Addresses

Primary practice location

7250 Clearvista Dr
Suite 327a
Indianapolis, IN 46256-4692

Mailing address

7250 Clearvista Dr
Suite 327a
Indianapolis, IN 46256-4692
Phone (317) 621-7390

National Provider Directory

National Provider Directory

Locations

7250 Clearvista Dr
Ste 327A
Indianapolis, IN 46256
Phone (317) 621-7390

Practitioners & affiliated clinicians

Practitioners 3

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": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1821281973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 CLEARVISTA DR",
            "address_2": "SUITE 327A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564692",
            "telephone_number": "317-621-7390",
            "fax_number": "317-621-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 CLEARVISTA DR",
            "address_2": "SUITE 327A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564692",
            "telephone_number": "317-621-7390",
            "fax_number": "317-621-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARVISTA RECOVERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-621-7390",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01028972",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01028972",
            "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 Jun 11, 2014; 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.