INDIANAPOLIS NEUROSURGICAL GROUP (NPI# 1336380617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336380617 |
| Entity Type | Organization |
| Organization Name | INDIANAPOLIS NEUROSURGICAL GROUP |
| Other Organization Name | GOODMAN CAMPBELL BRAIN AND SPINE |
| Practice Address |
1633 N Capitol Ave Ste 300 Indianapolis IN 46202-1261 |
| Mailing Address |
8333 Naab Rd Suite 250 Indianapolis IN 46260-5924 |
| Practice Telephone | 3173961300 |
| Practice Fax Number | 3173961346 |
| Mailing Telephone | 3173961300 |
| Mailing Fax Number | 3173961346 |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2009-12-29 |
| Authorized Official Name | MR. DEREK CANTRELL (CFO) |
| Authorized Official Telephone | 3173961300 |
| 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 |
| 1316276363 | Indianapolis Neurosurgical Group | Nurse Practitioner | 1115 Ronald Reagan Pkwy, Suite 148, Avon, IN 46123-6910 | 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 |
| 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 |
1633 N CAPITOL AVE STE 300 |
| 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 | 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 |
|---|---|---|---|---|
| 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 |
| 1730317090 | Graham Charles Hall | Neurological Surgery | 1550 E County Line Rd Ste 201, Indianapolis, IN 46227-1082 | 2009-06-25 |
| 1235131103 | Ronald L Young II | Neurological Surgery | 8333 Naab Rd, 250, Indianapolis, IN 46260-5924 | 2005-08-11 |
| 1790788321 | Scott A Shapiro | Neurological Surgery | 355 W 16th St, Suite 5100, Indianapolis, IN 46202-2207 | 2005-05-27 |
| 1518960004 | Jodi L Smith | Neurological Surgery | 702 Barnhill Dr, Suite 1134, Indianapolis, IN 46202-5128 | 2005-05-27 |
| 1104829746 | Michael B Pritz | Neurological Surgery | 1801 N Senate Blvd, Suite 535, Indianapolis, IN 46202-1291 | 2005-05-27 |
| 1518960186 | Joel C Boaz | Neurological Surgery | 201 Pennsylvania Pkwy, Ste 100, Indianapolis, IN 46260-1393 | 2005-05-27 |
| 1043213648 | Neurosurgical Associates of Indiana, PC | Neurological Surgery | 7369 Shadeland Station Way, Ste 100, Indianapolis, IN 46256-3958 | 2005-05-27 |
| 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.