NPIMap

Organization Active NPI

Indianapolis Neurosurgical Group

Doing business as Goodman Campbell Brain and Spine

  • Neurological Surgery Physician
  • Muncie, IN
National Provider Identifier
1942376926
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
INDIANAPOLIS NEUROSURGICAL GROUP
Doing business as
Goodman Campbell Brain and Spine
Practice address
2525 W University Ave
Suite 503
Muncie, IN 47303-3421
Phone
(765) 288-0441
Fax
(765) 282-7879
NPI assigned
Nov 28, 2006
Last updated
Apr 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Derek Cantrell
Title
Cfo
Phone
(317) 396-1386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

2525 W University Ave
Suite 503
Muncie, IN 47303-3421

Mailing address

8333 Naab Rd
Suite 250
Indianapolis, IN 46260-5924
Phone (317) 396-1300

Other identifiers 2

IdentifierTypeStateIssuer
200235010AMedicaidIN
200971560NMedicaidIN

Other names 1

  • Goodman Campbell Brain and Spine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goodman Campbell Brain and Spine21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Practitioners & affiliated clinicians

Practitioners 2

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1942376926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD",
            "address_2": "SUITE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605924",
            "telephone_number": "317-396-1300",
            "fax_number": "317-396-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W UNIVERSITY AVE",
            "address_2": "SUITE 503",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033421",
            "telephone_number": "765-288-0441",
            "fax_number": "765-282-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS NEUROSURGICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-396-1386"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200235010A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200971560N",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodman Campbell Brain and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.