INDIANAPOLIS NEUROSURGICAL GROUP (NPI# 1316276363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316276363 |
| Entity Type | Organization |
| Organization Name | INDIANAPOLIS NEUROSURGICAL GROUP |
| Other Organization Name | GOODMAN CAMPBELL BRAIN AND SPINE |
| Practice Address |
1115 Ronald Reagan Pkwy Suite 148 Avon IN 46123-6910 |
| Mailing Address |
8333 Naab Rd Suite 250 Indianapolis IN 46260-5924 |
| Practice Telephone | 3172783200 |
| Practice Fax Number | 3172783333 |
| Mailing Telephone | 3173961300 |
| Mailing Fax Number | 3173961346 |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2012-09-12 |
| Authorized Official Name | DEREK CANTRELL (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3173961300 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100318390 | 05 |
| Other Name | Type Code |
|---|---|
| Goodman Campbell Brain and Spine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669701629 | Indianapolis Neurosurgical Group | Nurse Practitioner | 702 Riley Hospital Dr, Suite 1134, Indianapolis, IN 46202-5139 | 2009-12-21 |
| 1154541753 | Indianapolis Neurosurgical Group | Radiologic Technologist | 1925 N. Capitol Avenue, Indianapolis, IN 46202 | 2007-04-26 |
| 1477883916 | Indianapolis Neurosurgical Group | Nurse Practitioner | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2010-01-06 |
| 1881923837 | Indianapolis Neurosurgical Group | Nurse Practitioner | 550 University Blvd, Uh 1295, Indianapolis, IN 46202-5149 | 2009-12-21 |
| 1689903635 | Indianapolis Neurosurgical Group | Nurse Practitioner | 1001 W 10th St, Rg 4th Floor, Indianapolis, IN 46202-2859 | 2009-12-21 |
| 1033448097 | Indianapolis Neurosurgical Group | Nurse Practitioner | 11725 N Illinois St, Suite 275, Carmel, IN 46032-3008 | 2009-12-21 |
| 1851620801 | Indianapolis Neurosurgical Group | Nurse Practitioner | 535 Barnhill Dr, Rt, 2nd Floor, Indianapolis, IN 46202-5116 | 2009-12-21 |
| 1336380617 | Indianapolis Neurosurgical Group | Nurse Practitioner | 1633 N Capitol Ave, Ste 300, Indianapolis, IN 46202-1261 | 2009-03-16 |
| 1679733166 | Indianapolis Neurosurgical Group | Physical Medicine & Rehabilitation | 355 W 16th St, Suite 5100, Indianapolis, IN 46202-2207 | 2008-06-10 |
| 1093905325 | Indianapolis Neurosurgical Group | General Acute Care Hospital | 1801 N Senate Ave, Suite 535, Indianapolis, IN 46202 | 2007-08-01 |
| Street Address |
1115 RONALD REAGAN PKWY SUITE 148 |
| City | AVON |
| State | IN |
| Zip Code | 46123-6910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679573620 | James C Sloan | Urology | 1115 Ronald Reagan Pkwy, Ste 364, Avon, IN 46123-6910 | 2005-07-29 |
| 1487111274 | Ann Shackelford Reeves | Nurse Practitioner | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2019-02-27 |
| 1215412432 | Heather Renee Seaborne | Registered Nurse | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2018-10-03 |
| 1770959744 | Chelsea Durnil | Pharmacist | 1115 Ronald Reagan Pkwy, Ste 318, Avon, IN 46123-6910 | 2015-08-13 |
| 1578961314 | Urology of Indiana L.l. C. | Durable Medical Equipment & Medical Supplies | 1115 Ronald Reagan Pkwy, Suite 247, Avon, IN 46123-6910 | 2014-12-10 |
| 1639445315 | Thomas A Brady Sports Medicine Ctr | Durable Medical Equipment & Medical Supplies | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2012-03-28 |
| 1912290925 | Kyle Andrew Frick | Internal Medicine | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2011-05-24 |
| 1831405422 | Amanda N Crishon | Audiologist | 1115 Ronald Reagan Pkwy, Ste 225, Avon, IN 46123-6910 | 2010-08-20 |
| 1831410703 | Robert Neal Ingram | Registered Nurse | 1115 Ronald Reagan Pkwy, Pkwy 171, Avon, IN 46123-6910 | 2010-06-15 |
| 1750614400 | Lauren D Fahey | Physician Assistant | 1115 Ronald Reagan Pkwy, Suite 348, Avon, IN 46123-6910 | 2009-09-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018669 | Dienye Williams | Pharmacist | 108 North Sr 267, Avon, IN 46123 | 2019-11-25 |
| 1992353817 | Debra Blackwell | Technician | 8198 Montage Ave, Apt 104, Avon, IN 46123 | 2019-09-04 |
| 1932675766 | Blake Ponist | Occupational Therapist | 10940 E U S Highway 36, Rockville Rd, Avon, IN 46123 | 2018-10-19 |
| 1396238150 | Sarah Sweany | Dietitian, Registered | Iu Health West Cancer Center, 1111 North Ronald Reagen Pkwy Suite B1600, Avon, IN 46123 | 2018-06-07 |
| 1124516257 | Sheree Itza | Counselor | 6655 E Us Highway 36 Ste 100, Avon, IN 46123 | 2018-04-24 |
| 1255860607 | Jonathan Lambert | Dentist | 110 N Avon Ave B, Avon, IN 46123 | 2017-06-08 |
| 1023546629 | 10439 E Us Highway 36 Dental, LLC | Dentist | 10439 E Us Highway 36, Avon, IN 46123 | 2017-05-25 |
| 1902330756 | Melissa Wheatley | Occupational Therapy Assistant | 6294 Forest View Court, Avon, IN 46123 | 2017-04-19 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1962871301 | Annette Joelene Oechsle | Health Educator | 1820 South County Road 525 East, Avon, IN 46123 | 2015-09-16 |
| Find all providers in zip 46123 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861664682 | David William Stockwell | Neurological Surgery | 1115 Ronald Reagan Pkwy, Suite 283, Goodman Campbell Brain and Spine, Avon, IN 46123-6910 | 2008-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780146076 | T.s.shanks, Pllc | Neurological Surgery | 1919 State St Ste 250, New Albany, IN 47150-6805 | 2019-04-04 |
| 1326411158 | Stephen B Schroeder | Neurological Surgery | 2318 Turnberry Lane, Fort Wayne, IN 46804 | 2015-11-02 |
| 1326465725 | Hayder Jaffer | Neurological Surgery | 200 E 89th Ave Ste 3a, Merrillville, IN 46410-7319 | 2014-03-24 |
| 1083956015 | Us Medical & Business Consultants LLC | Neurological Surgery | 899 S College Mall Rd Ste 350, Bloomington, IN 47401-6301 | 2013-03-15 |
| 1659646917 | Shaheryar Faruq Ansari | Neurological Surgery | 8040 Clearvista Pkwy Ste 240, Indianapolis, IN 46256-4673 | 2012-03-19 |
| 1629367354 | Katrina Alise Ducis | Neurological Surgery | 705 Riley Hospital Dr Rm 1134, Indianapolis, IN 46202 | 2011-04-04 |
| 1639490857 | Karl Erach Balsara | Neurological Surgery | 705 Riley Hospital Dr # 1134, Indianapolis, IN 46202 | 2010-06-22 |
| 1265759955 | Chih-ta Lin | Neurological Surgery | 2525 W University Ave Ste 503, Muncie, IN 47303-3409 | 2010-04-21 |
| 1093030322 | Gregory J Loomis | Neurological Surgery | 1024 Dress Ln, Evansville, IN 47725-9596 | 2010-03-30 |
| 1730317090 | Graham Charles Hall | Neurological Surgery | 1550 E County Line Rd Ste 201, Indianapolis, IN 46227-1082 | 2009-06-25 |
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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.