Physician Provider Services LLC

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

Legal business name

PHYSICIAN PROVIDER SERVICES LLC

Practice address

900 N High School Rd
Indianapolis, IN 46214-3759

Phone

(800) 526-6797

NPI assigned

Mar 15, 2024

Last updated

May 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andre Creese

Title

Ceo

Phone

(317) 672-8600

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1982463600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDIANA SQ STE 2060",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N HIGH SCHOOL RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143759",
            "telephone_number": "800-526-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN PROVIDER SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "CREESE",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-672-8600"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.