TRACEY WILKINSON (NPI# 1003034562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003034562 |
| Entity Type | Individual |
| Full Name | TRACEY WILKINSON |
| Credential | MD |
| Practice Address |
1633 N Capitol Ave Suite 236 Indianapolis IN 46202-1261 |
| Mailing Address |
3403 E Raymond St Indianapolis IN 46203-4744 |
| Practice Telephone | 3179628067 |
| Practice Fax Number | 3179623796 |
| Mailing Telephone | 3179572000 |
| Mailing Fax Number | 3179572050 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2015-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 01075861A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201313510 | 05 |
| Street Address |
1633 N CAPITOL AVE SUITE 236 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46202-1261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275537946 | Michele L. Saysana | Pediatrics | 1633 N Capitol Ave, Ste 236, Indianapolis, IN 46202-1261 | 2005-06-09 |
| 1740801711 | Eric Joseph Cooper | Nurse Practitioner | 1633 N Capitol Ave, Indianapolis, IN 46202-1261 | 2020-05-01 |
| 1922654227 | Allison Garrison | Nurse Practitioner | 1633 N Capitol Ave, Indianapolis, IN 46202-1261 | 2019-08-13 |
| 1811553662 | Heather R Martin | Nurse Practitioner | 1633 N Capitol Ave, Indianapolis, IN 46202-1261 | 2019-05-17 |
| 1902462286 | Anne Merrylees Dersch | Student in an Organized Health Care Education/Training Program | 1633 N Capitol Ave, Indianapolis, IN 46202-1261 | 2019-05-13 |
| 1245720986 | Andrew Adams | Student in an Organized Health Care Education/Training Program | 1633 N Capitol Ave, Indianapolis, IN 46202-1261 | 2018-05-17 |
| 1801385059 | Allison Kade Fox | Student in an Organized Health Care Education/Training Program | 1633 N Capitol Ave, Methodist Tower, Ste 640, Indianapolis, IN 46202-1281 | 2018-05-03 |
| 1467958785 | Omar Bari | Student in an Organized Health Care Education/Training Program | 1633 N Capitol Ave, Indianapolis, IN 46202-1261 | 2018-04-04 |
| 1487191276 | Angela Rhea Boyle | Nurse Practitioner | 1633 N Capitol Ave, Suite 322, Indianapolis, IN 46202-1261 | 2017-01-31 |
| 1598200156 | Emily Huesgen | Pharmacist | 1633 N Capitol Ave, Suite 300, Indianapolis, IN 46202-1261 | 2017-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
| 1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
| 1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
| 1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
| 1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
| 1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
| Find all providers in zip 46202 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447780069 | Ann Freshour | Pediatrics | 575 Riley Hospital Dr Ste Xe-040, Indianapolis, IN 46202-5272 | 2017-06-15 |
| 1700339983 | Buria Naeem | Pediatrics | 705 Riley Hospital Dr Rm 4900, Indianapolis, IN 46202-5109 | 2016-07-25 |
| 1013362839 | Christine Nix | Pediatrics | 750 Riley Hospital Drive, Room 5867, Indianapolis, IN 46202-5209 | 2016-04-29 |
| 1477915791 | Sarah Patton Supples | Pediatrics | 705 Riley Hospital Dr Roc4340, Indianapolis, IN 46202 | 2016-03-25 |
| 1801283205 | Korre Leigh Fairman | Pediatrics | 1030 W Michigan St Ste C4600, Indianapolis, IN 46202 | 2015-04-23 |
| 1912393240 | Dana Nezon | Pediatrics | Windrose Health Network - Epler Park, 5550 S. East St., Indianapolis, IN 46227 | 2015-04-14 |
| 1922412162 | Jodie Meara | Pediatrics | Riley Children's Hospital Ri 3006 Phase IIi, 705 Riley Hospital Drive, Indianapolis, IN 46202 | 2014-06-16 |
| 1265877690 | Kristen Mary Schroeder | Pediatrics | 1002 Wishard Blvd Ste 4110, Indianapolis, IN 46202-2872 | 2013-04-29 |
| 1396189056 | Jessica Lucille Horan | Pediatrics | 699 Riley Hospital Dr, Room Rr 208, Indianapolis, IN 46202-5119 | 2013-04-24 |
| 1841581311 | Meaghan Elisabeth Keller | Pediatrics | 8414 Naab Rd Ste 200, Indianapolis, IN 46260-1972 | 2011-05-02 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46202 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.