NPIMap

Organization Active NPI

Indiana Spine Group, PC

  • Orthopaedic Surgery of the Spine Physician
  • Kokomo, IN
National Provider Identifier
1861679094
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
INDIANA SPINE GROUP, PC
Practice address
821 N Dixon Rd
Kokomo, IN 46901-1754
Phone
(765) 450-0111
Fax
(765) 553-5504
NPI assigned
Jan 30, 2008
Last updated
May 27, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
INDIANA SPINE GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Authorized official

Name
Hardeep Sikand
Title
Ceo
Phone
(317) 228-7000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Orthopaedic Surgery of the Spine Physician 207XS0117X NU Primary
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

821 N Dixon Rd
Kokomo, IN 46901-1754

Mailing address

13225 N Meridian St
Carmel, IN 46032-5480
Phone (317) 228-7000

Other identifiers 5

IdentifierTypeStateIssuer
CJ8084OtherINMEDICARE RAILROAD
200359410-CMedicaidIN
366735000OtherINUS POSTAL SERVICE WORKERS
000000214063OtherINANTHEM GROUP NUMBER
366735000OtherINUS DEPARTMENT OF LABOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308001261 IN Part B Supplier - Clinic/Group Practice 4082502349 Receives reassigned benefits from 52 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomington, IN; Anderson, IN; Zionsville, IN; Westfield, IN; West Lafayette, IN; Vincennes, IN; Terre Haute, IN; Shelbyville, IN…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Indiana Spine Group PC

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

821 N Dixon Rd
Kokomo, IN 46901
Phone (765) 450-0111

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1861679094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13225 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325480",
            "telephone_number": "317-228-7000",
            "fax_number": "317-228-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469011754",
            "telephone_number": "765-450-0111",
            "fax_number": "765-553-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA SPINE GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIANA SPINE GROUP, PC",
        "enumeration_date": "2008-01-30",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "SIKAND",
        "authorized_official_first_name": "HARDEEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-228-7000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ8084",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200359410-C",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US POSTAL SERVICE WORKERS",
            "identifier": "366735000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "000000214063",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "366735000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.