Madison Avenue Medical Laboratory Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MADISON AVENUE MEDICAL LABORATORY INC.

Practice address

8523 Madison Avenue
Suite B
Indianapolis, IN 46227

Phone

(317) 887-6407

Fax

(317) 887-6309

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Larry Wayne Miller

Title

President

Phone

(317) 887-6407

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1841358173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8523 MADISON AVENUE",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46227",
            "telephone_number": "317-887-6407",
            "fax_number": "317-887-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8523 MADISON AVENUE",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46227",
            "telephone_number": "317-887-6407",
            "fax_number": "317-887-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AVENUE MEDICAL LABORATORY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-887-6407"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100283920A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie J Maddox, PTA
• Zach Madere
• Deepthi Madhavarapu
• Meenakshi Swaminathan Madhur, MD., PHD
• Karen Sue Madinger, RPH
• Madison Health Care Center
• Madison Health Care Properties LLC
• Brenda Elisa Madison, PT
• David L Madison, MD
• Mackenzie K Madison, MD

• Clinical Medical Laboratory in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.