Active NPI
Michelle Gomez
- Psychologist
- Indianapolis, IN
National Provider Identifier
1992526677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10279721
- Practice address
- 9010 E Southport Rd
Indianapolis, IN 46259-9813 - Phone
- (317) 860-4722
- NPI assigned
- Oct 24, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 10279721 | IN | Primary |
Addresses
Primary practice location
9010 E Southport Rd
Indianapolis, IN 46259-9813
Mailing address
765 Wood Dale Ter
Greenwood, IN 46142-3988
Other practice location 1
6620 Shelbyville Rd
Indianapolis, IN 46237-9720
Phone (317) 860-4722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10279721 | IN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1992526677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 WOOD DALE TER",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461423988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9010 E SOUTHPORT RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462599813",
"telephone_number": "317-860-4722"
}
],
"practiceLocations": [
{
"address_1": "6620 Shelbyville Rd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462379720",
"country_code": "US",
"telephone_number": "317-860-4722",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOMEZ",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-24",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "10279721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.