Active NPI
Geriatric Psychiatric Services PLLC
- Nurse Practitioner
- Indianapolis, IN
National Provider Identifier
1891935144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- GERIATRIC PSYCHIATRIC SERVICES PLLC
- Practice address
- 9465 Counselors Row
Suite 200
Indianapolis, IN 46240-6423 - Phone
- (586) 620-8100
- Fax
- (866) 227-7418
- NPI assigned
- Feb 26, 2009
- Organization subpart
- Yes
- Parent organization
- TOTAL CARE SOLUTIONS, SC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert A Clemente, ESQ.
- Title
- Admin Director
- Phone
- (586) 620-8100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
9465 Counselors Row
Suite 200
Indianapolis, IN 46240-6423
Mailing address
28800 Ryan Rd
Suite 320
Warren, MI 48092-4272
Phone (586) 620-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090424000362 | IN | Part B Supplier - Clinic/Group Practice | 6204837388 |
Receives reassigned benefits from 1 practitioner 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Indianapolis, IN |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinical Psychologist
- Indianapolis, IN
- NPI 1073753323
O20090424000362
-
- Clinical Social Worker
- Indianapolis, IN
- NPI 1528208873
O20090424000362
-
- Psychiatry Physician
- Indianapolis, IN
- NPI 1881834125
O20090424000362
National Provider Directory
National Provider Directory- Part of
- Total Care Solutions SC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235606400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1421280000000",
"number": "1891935144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28800 RYAN RD",
"address_2": "SUITE 320",
"city": "WARREN",
"state": "MI",
"postal_code": "480924272",
"telephone_number": "586-620-8100",
"fax_number": "866-227-7418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9465 COUNSELORS ROW",
"address_2": "SUITE 200",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462406423",
"telephone_number": "586-620-8100",
"fax_number": "866-227-7418"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GERIATRIC PSYCHIATRIC SERVICES PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TOTAL CARE SOLUTIONS, SC",
"enumeration_date": "2009-02-26",
"last_updated": "2015-01-15",
"status": "A",
"authorized_official_last_name": "CLEMENTE",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "ADMIN DIRECTOR",
"authorized_official_telephone_number": "586-620-8100",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "ESQ."
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"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 Jan 15, 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.