St. Mary Adult Medicine, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ST. MARY ADULT MEDICINE, LLC

Practice address

4803 W 71St St
Indianapolis, IN 46268-2149

Phone

(317) 293-9039

Fax

(855) 538-6177

NPI assigned

Nov 19, 2007

Organization subpart

No

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

Authorized official

Name

Dina M Mourice, NPNPI 1619336096

Title

NP

Phone

(317) 293-9039

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JIEJDD

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dina M Mourice, AGNP-C

  • Adult Health Nurse Practitioner
  • Indianapolis, IN
  • NPI 1619336096
  Medicare reassignment Care Compare group Authorized official
• Malak Gadalla Hermina, MD FACP

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1366496119
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786752000000",
    "number": "1942481965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 W 71ST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462682149",
            "telephone_number": "317-293-9039",
            "fax_number": "855-538-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 W 71ST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462682149",
            "telephone_number": "317-293-9039",
            "fax_number": "855-538-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY ADULT MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A",
        "authorized_official_last_name": "MOURICE",
        "authorized_official_first_name": "DINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "317-293-9039",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201378550",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole St. Germain, MD
• Madeleine L St. James, FNP-C
• Darcy St. John, CTRS
• St. Joseph Institute for the Deaf Indiana Service Corporation
• St. Joseph Institute for the Deaf Indianapolis
• St. Mary Rehabilitation and Health
• St. Mary'S Child Center
• St. Mary'S Child Center
• St. Vincent
• St. Vincent

• General Practice Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2026; 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.