Organization Active NPI

Zenith Healthcare, LLC

  • Cardiovascular Disease Physician
  • Indianapolis, IN
National Provider Identifier
1831510338
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01039628A Issued in IN
Legal business name
ZENITH HEALTHCARE, LLC
Practice address
3737 N Meridian St
Suite 104
Indianapolis, IN 46208-4348
Phone
(317) 584-4004
Fax
(317) 584-4008
NPI assigned
Dec 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Authorized official

Name
Dr. Bertram Anthony Graves, M.D.NPI 1821186933
Title
President
Phone
(317) 584-4004

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 01039628A IN
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 01039628A IN Primary

Addresses

Primary practice location

3737 N Meridian St
Suite 104
Indianapolis, IN 46208-4348

Mailing address

3737 N Meridian St
Suite 104
Indianapolis, IN 46208-4348
Phone (317) 584-4004

Other identifiers 1

IdentifierTypeStateIssuer
201211980MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141029002474 IN Part B Supplier - Clinic/Group Practice 7618198953 Receives reassigned benefits from 1 practitioner
Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

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": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1831510338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 N MERIDIAN ST",
            "address_2": "SUITE 104",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084348",
            "telephone_number": "317-584-4004",
            "fax_number": "317-584-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 N MERIDIAN ST",
            "address_2": "SUITE 104",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084348",
            "telephone_number": "317-584-4004",
            "fax_number": "317-584-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZENITH HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-31",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "BERTRAM",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-584-4004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01039628A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01039628A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201211980",
            "state": "IN"
        }
    ],
    "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 Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.