NPIMap

Organization Active NPI

Pediatric Neuropsychology Associates

  • Clinical Neuropsychologist
  • Indianapolis, IN
National Provider Identifier
1922011089
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
20040858A Issued in IN
Legal business name
PEDIATRIC NEUROPSYCHOLOGY ASSOCIATES
Practice address
1801 Senate Blvd
Suite 770
Indianapolis, IN 46202-1228
Phone
(317) 962-2594
Fax
(317) 962-1895
NPI assigned
Aug 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bryan A Hudson, PH.D.
Title
Owner
Phone
(317) 962-2594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 20040858A IN Primary

Addresses

Primary practice location

1801 Senate Blvd
Suite 770
Indianapolis, IN 46202-1228

Mailing address

1427 W 86TH St
Suite 245
Indianapolis, IN 46260-2103
Phone (317) 962-2594

National Provider Directory

National Provider Directory

Locations

1801 Senate Blvd
Ste 770
Indianapolis, IN 46202
Phone (317) 962-2594

Practitioners & affiliated clinicians

Practitioners 4

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": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922011089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 W 86TH ST",
            "address_2": "SUITE 245",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602103",
            "telephone_number": "317-962-2594",
            "fax_number": "317-962-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SENATE BLVD",
            "address_2": "SUITE 770",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021228",
            "telephone_number": "317-962-2594",
            "fax_number": "317-962-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROPSYCHOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-962-2594",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20040858A",
            "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 Aug 22, 2020; 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.