Individual provider Active NPI

Evan Ray Eckart, MD

  • Pediatrics Physician
  • Shelbyville, IN
National Provider Identifier
1952466435
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01063201A Issued in IN
Practice address
30 W Rampart St
Suite 170
Shelbyville, IN 46176-8846
Phone
(317) 398-7537
Fax
(317) 421-0372
NPI assigned
Dec 26, 2006
Last updated
Apr 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01063201A IN Primary

Addresses

Primary practice location

30 W Rampart St
Suite 170
Shelbyville, IN 46176-8846

Mailing address

30 W Rampart St Ste 200
Shelbyville, IN 46176-8846
Phone (317) 421-2012

Other identifiers 1

IdentifierTypeStateIssuer
200867260MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071016000111 IN Practitioner - Pediatric Medicine 8325134778 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Physicians of Shelbyville PC Current Accepting new patients
Major Hospital CurrentSince Apr 1, 2019 Accepting new patients
Major Hospital CurrentSince Apr 1, 2019 Accepting new patients
Major Hospital Past Accepting new patients
Major Multispecialty Associates Pediatrics Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

2451 Intelliplex Dr
Ste 24
Shelbyville, IN 46176
Phone (317) 398-7337

2451 Intelliplex Dr
Ste 240
Shelbyville, IN 46176
Phone (317) 398-7337

30 W Rampart St
Ste 170
Shelbyville, IN 46176
Phone (317) 382-3651

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

30 W Rampart St
Ste 250
Shelbyville, IN 46176
Phone (317) 398-7337

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1952466435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST",
            "address_2": "SUITE 170",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-398-7537",
            "fax_number": "317-421-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKART",
        "first_name": "EVAN",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01063201A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200867260",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.