Organization Active NPI

Patient Care Services Team

  • Gerontology Nurse Practitioner
  • Noblesville, IN
National Provider Identifier
1962822106
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
PATIENT CARE SERVICES TEAM
Practice address
939 Conner St Ste 200
Noblesville, IN 46060-2622
Phone
(317) 219-7588
NPI assigned
Apr 25, 2014
Last updated
Aug 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Authorized official

Name
Daniel Hollis
Title
Owner
Phone
(317) 744-5368

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NU Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU
Primary Podiatric Medicine Podiatrist 213EP1101X NU

Addresses

Primary practice location

939 Conner St Ste 200
Noblesville, IN 46060-2622

Mailing address

10505 Hawks Ridge CT
Fishers, IN 46037-9258
Phone (317) 730-4910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141117000768 IN Part B Supplier - Clinic/Group Practice 9537381066 Receives reassigned benefits from 5 practitioners
Practice locations: Fishers, IN

National Provider Directory

National Provider Directory

Locations

939 Conner St
Ste 200
Noblesville, IN 46060
Phone (317) 219-7588

Practitioners & affiliated clinicians

Practitioners 5

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": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1962822106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 HAWKS RIDGE CT",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379258",
            "telephone_number": "317-730-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 CONNER ST STE 200",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602622",
            "telephone_number": "317-219-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENT CARE SERVICES TEAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "HOLLIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-744-5368"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.