INDIANA CANCER SPECIALISTS, LLC (NPI# 1780124586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780124586 |
| Entity Type | Organization |
| Organization Name | INDIANA CANCER SPECIALISTS, LLC |
| Practice Address |
8301 Harcourt Rd Suite 205 Indianapolis IN 46260-2081 |
| Practice Telephone | 3172283393 |
| Practice Fax Number | 3178761305 |
| Mailing Telephone | 3172283393 |
| Mailing Fax Number | 3178761305 |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |
| Authorized Official Name | SRIDHAR BOLLA (PRESIDENT) |
| Authorized Official Telephone | 3172283393 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336689702 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 8301 Harcourt Rd, Suite 205, Indianapolis, IN 46260-2081 | 2017-03-03 |
| 1366982910 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 1706 Lafayette Rd, Crawfordsville, IN 47933-1033 | 2017-03-01 |
| 1811437460 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 1111 Ronald Reagan Pkwy, Suite B1500, Avon, IN 46123-7085 | 2017-03-01 |
| 1902346562 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 100 Hospital Ln, Suite 320, Danville, IN 46122-1989 | 2017-03-01 |
| 1720528383 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2017-03-01 |
| Street Address |
8301 HARCOURT RD SUITE 205 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46260-2081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588663983 | Raymond M Harwood | Internal Medicine | 8301 Harcourt Rd, Ste 200, Indianapolis, IN 46260-2081 | 2005-07-18 |
| 1336689702 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 8301 Harcourt Rd, Suite 205, Indianapolis, IN 46260-2081 | 2017-03-03 |
| 1790171015 | Kristen Kay Schmidt | Registered Nurse | 8301 Harcourt Rd, Suite 205, Indianapolis, IN 46260-2081 | 2015-04-13 |
| 1336421650 | Karen Elizabeth Grooms | Nurse Practitioner | 8301 Harcourt Rd, Suite 205, Indianapolis, IN 46260-2081 | 2011-09-13 |
| 1942435797 | Julia Joyce Compton | Radiology | 8301 Harcourt Rd, Indianapolis, IN 46260-2081 | 2009-05-22 |
| 1316116700 | Cancer Care Group, P.C. | Radiology | 8301 Harcourt Rd, Indianapolis, IN 46260-2081 | 2008-02-29 |
| 1396938429 | Diane Elaine Funk | Nurse Practitioner | 8301 Harcourt Rd, Radiation Oncology Dept, Ste 100, Indianapolis, IN 46260-2081 | 2007-08-22 |
| 1346324969 | Indiana Womens Oncology PC | Obstetrics & Gynecology | 8301 Harcourt Rd, Ste 201, Indianapolis, IN 46260 | 2006-10-24 |
| 1356436414 | Christopher Alan Leagre | Radiology | 8301 Harcourt Rd, Suite 100, Indianapolis, IN 46260 | 2006-10-04 |
| 1932123205 | Fadi Hayek | Internal Medicine | 8301 Harcourt Rd, Suite 205, Indianapolis, IN 46260-2081 | 2006-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
| 1225666589 | Alexander Michael Kiel | Student in an Organized Health Care Education/Training Program | Internal Medicine 3 North, 2001 W. 86th Street, Indianapolis, IN 46260 | 2020-03-31 |
| 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 |
| 1912483215 | Katherine Donnelly | Community Health Worker | 1612 Lancashire Ct, Indianapolis, IN 46260 | 2018-07-19 |
| 1326539628 | Peaceful Source Midwifery LLC | Advanced Practice Midwife | 1139 Canterbury Ct., Unit B, Indianapolis, IN 46260 | 2018-05-22 |
| 1144722695 | Mindful Services Center LLC | Clinic/Center | 9002 N Meridian St, Ste 200, Indianapolis, IN 46260 | 2018-03-01 |
| 1144731910 | Meenu Jain | Student in an Organized Health Care Education/Training Program | Internal Medicine, 8414 Naab Road, Suite 100, Indianapolis, IN 46260 | 2017-10-19 |
| 1609392422 | 1717 Senior Living, LLC | Assisted Living Facility | 1703 West 86th Street, Indianapolis, IN 46260 | 2017-08-15 |
| 1093246985 | Royalty Transports LLC | Bus | 2255 W. 67th St., Indianapolis, IN 46260 | 2017-03-23 |
| Find all providers in zip 46260 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033451083 | Richard Brian Gaynor | Internal Medicine | Eli Lilly and Company Corporate Ctr, Indianapolis, IN 46285-0001 | 2013-03-17 |
| 1760798326 | Redmond Prindiville Hogan IIi | Internal Medicine | 2808 W 44th St, Indianapolis, IN 46228-3147 | 2010-08-20 |
| 1720392798 | Mohammad Issam Abu Zaid | Internal Medicine | 535 Barnhill Drive, Rt 473, Indiana Univeristy/hematology Oncology, Indianapolis, IN 46202-5147 | 2010-08-02 |
| 1497998520 | Ashwin Kolala Vasudevamurthy | Internal Medicine | 8301 Harcourt Rd Ste 205, Indianapolis, IN 46260 | 2009-04-20 |
| 1558547588 | Sarah Ali | Internal Medicine | 8111 S Emerson Ave Ste 102, Indianapolis, IN 46237-8601 | 2008-01-22 |
| 1821274101 | Oncology Hematology Care Center Inc | Internal Medicine | 1440 E County Line Rd, Indianapolis, IN 46227-0963 | 2008-01-16 |
| 1659582120 | American Health Network of Indiana, LLC | Internal Medicine | 1828 N Illinois St, Indianapolis, IN 46202-1318 | 2007-05-25 |
| 1669687331 | Indiana Oncology Hematology Consultants | Internal Medicine | 6925 Shore Ter, Indianapolis, IN 46254-4675 | 2007-05-14 |
| 1306065446 | Taylor M Ortiz | Internal Medicine | 8111 S. Emerson Ave Suite 101, Indianapolis, IN 46237-8325 | 2007-04-25 |
| 1164567871 | Christopher Alan Slapak | Internal Medicine | The Wishard Hospital Hematology Clinic, 1050 Wishard Blvd, Indianapolis, IN 46202 | 2007-02-20 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46260 |
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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.