NORTHSIDE GASTROENTEROLOGY ENDOSCOPY CENTER LLC (NPI# 1659344133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659344133 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE GASTROENTEROLOGY ENDOSCOPY CENTER LLC |
| Other Organization Name | NORTHSIDE GASTROENTEROLOGY ENDOSCOPY CENTER |
| Practice Address |
8424 Naab Rd Suite 3-g Indianapolis IN 46260-5918 |
| Mailing Address |
1a Burton Hills Blvd Attn: L&c Nashville TN 37215-6103 |
| Practice Telephone | 3178717308 |
| Practice Fax Number | 3178717314 |
| Mailing Telephone | 3178717308 |
| Mailing Fax Number | 3178717314 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2014-12-02 |
| Authorized Official Name | MR. PHILLIP CLENDENIN (PRESIDENT) |
| Authorized Official Telephone | 6156651283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
05-008902 | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200119350A | 05 | |
| IN | RAILROAD MEDICARE | 490003884 | 01 |
| Other Name | Type Code |
|---|---|
| Northside Gastroenterology Endoscopy Center | Doing Business As Name - Organization |
| Street Address |
8424 NAAB RD SUITE 3-G |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46260-5918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881699296 | Nikhil Mulji Patel | Colon & Rectal Surgery | 8424 Naab Rd, Ste 2m, Indianapolis, IN 46260-1966 | 2005-06-14 |
| 1194078469 | Lisa Renee Schoenrock | Nurse Anesthetist, Certified Registered | 8424 Naab Rd, Suite 3 J, Indianapolis, IN 46260-5918 | 2012-10-23 |
| 1336478890 | Holistic Medical and Wellness Center of In, LLC | Clinic/Center | 8424 Naab Rd, Suite 3p, Indianapolis, IN 46260-5918 | 2009-12-12 |
| 1679731046 | Spencer Allison Wilson | Internal Medicine | 8424 Naab Rd, Suite 3j, Indianapolis, IN 46260-5918 | 2008-06-01 |
| 1356533996 | Adult Medicine Center | Internal Medicine | 8424 Naab Rd, Suite 3p, Indianapolis, IN 46260-5918 | 2007-08-17 |
| 1508901034 | Oldrich J Kolar, Md PC | Psychiatry & Neurology | 8424 Naab Rd, Suite 1a, Indianapolis, IN 46260-5918 | 2007-02-21 |
| 1437204625 | David Homer Kingsbury | Dermatology | 8424 Naab Rd, Suite 2b, Indianapolis, IN 46260-1966 | 2007-01-25 |
| 1114087749 | Michelle Leigh Myers | Nurse Practitioner | 8424 Naab Rd, Suite 2j, Indianapolis, IN 46260-5918 | 2006-12-12 |
| 1205914660 | Karen D Rodman | Psychiatry & Neurology | 8424 Naab Rd, Suite 1a, Indianapolis, IN 46260-5918 | 2006-11-02 |
| 1073605184 | John L George, Md | Surgery | 8424 Naab Rd, Suite #2f, Indianapolis, IN 46260-5918 | 2006-09-28 |
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| 1043793151 | Lisa R Foreman | Registered Nurse | 1389 W. 86th Street Unit # 238, Indianapolis, IN 46260 | 2018-09-13 |
| 1790268399 | Esther Muturi | Chore Provider | 1214 Racquetclub South Drive Apt C, Indianapolis, IN 46260 | 2018-09-10 |
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| 1093246985 | Royalty Transports LLC | Bus | 2255 W. 67th St., Indianapolis, IN 46260 | 2017-03-23 |
| Find all providers in zip 46260 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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|---|---|---|---|---|
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| 1558876037 | Beltway Surgery Centers, LLC | Clinic/Center | 9660 E Washington St Ste 200, Indianapolis, IN 46229-3032 | 2017-12-06 |
| 1548785116 | Nephrology & Internal Medicine, Inc. | Clinic/Center | 1420 N Senate Ave Ste A, Indianapolis, IN 46202-2211 | 2017-08-04 |
| 1669816799 | Advanced Surgery of Indiana LLC | Clinic/Center | 9470 Bridgewater Cir, Indianapolis, IN 46250-3412 | 2013-04-19 |
| 1275881179 | Eagle Highlands Surgery Center, LLC | Clinic/Center | 8830 S Meridian St, Indianapolis, IN 46217-5029 | 2012-08-27 |
| 1346596566 | Scp Indianapolis LLC | Clinic/Center | 7430 N Shadeland Ave Ste 100, Indianapolis, IN 46250-2036 | 2012-07-25 |
| 1023373834 | Midwest Specialty Surgery Center, LLC | Clinic/Center | 6920 Gatwick Dr., Suite 100, Indianapolis, IN 46241-9506 | 2012-07-08 |
| 1679892913 | Beltway Surgery Centers, L.L.C. | Clinic/Center | 550 University Blvd Ste 4100, Indianapolis, IN 46202-5149 | 2010-05-26 |
| 1326286360 | North Campus Surgery Center LLC | Clinic/Center | 8040 Clearvista Pkwy Ste 150, Indianapolis, IN 46256-4673 | 2009-01-29 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46260 |
Please comment or provide details below to improve the information on NORTHSIDE GASTROENTEROLOGY ENDOSCOPY CENTER LLC.
| 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.