ELEVATED DIAGNOSTIC IMAGING AND PAIN MANAGEMENT CENTER LLC (NPI# 1972829372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972829372 |
| Entity Type | Organization |
| Organization Name | ELEVATED DIAGNOSTIC IMAGING AND PAIN MANAGEMENT CENTER LLC |
| Other Organization Name | EDI LLC. |
| Practice Address |
1642 Olive Branch Park Ln Greenwood IN 46143-6447 |
| Mailing Address |
5045 Brookstone Ln Indianapolis IN 46268-5420 |
| Practice Telephone | 3175041665 |
| Mailing Telephone | 3175041665 |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |
| Authorized Official Name | MR. KEVIN LAMONT JOHNSON (CEO/OWNER) |
| Authorized Official Telephone | 3175041665 |
| Authorized Official Credential | RT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
261QM1200X | IN | Ambulatory Health Care Facilities |
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
261QM1300X | IN | Ambulatory Health Care Facilities |
| N | 261QP1100X |
Clinic/Center Specialization: Podiatric |
261QP1100X | IN | Ambulatory Health Care Facilities |
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
261QR0200X | IN | Ambulatory Health Care Facilities |
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
261QP3300X | IN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| EDI llc. | Other Name - Individual/Organization |
| Street Address |
1642 OLIVE BRANCH PARK LN |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-6447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
| Find all providers in zip 46143 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902463342 | Vigilance Anesthesiologists & Pain Specialists PC | Clinic/Center | 5363 Commerce Blvd Ste 100, Crown Point, IN 46307-5325 | 2019-05-21 |
| 1902213671 | Spahaute Company | Clinic/Center | 680 E Springhill Dr, Terre Haute, IN 47802-6804 | 2014-07-15 |
| 1689813669 | True Care Chiropractic, Inc | Clinic/Center | 12813 W 150 N, Linton, IN 47441-6304 | 2009-02-13 |
| 1962650218 | Midwest Pain Clinic | Clinic/Center | 907 Washington St, Michigan City, IN 46360-3517 | 2008-08-28 |
| 1962401745 | Midwest Pain Management Centers,llc | Clinic/Center | 8840 Calumet Ave, Suite 103, Munster, IN 46321-2529 | 2005-07-14 |
| 1407487119 | Advanced Lifestyle Care PC | Clinic/Center | 6195 Marcella Blvd, Hobart, IN 46342-0040 | 2020-01-31 |
| 1447891130 | Sage Interventional Pain Medicine | Clinic/Center | 1169 N Main St Ste 7, Bluffton, IN 46714-1362 | 2019-10-03 |
| 1114482122 | Pro Surge Indy LLC | Clinic/Center | 4725 Statesmen Dr Ste B, Indianapolis, IN 46250-5645 | 2019-02-04 |
| 1235687666 | Green Surgical, LLC. | Clinic/Center | 8687 Connecticut St, Suite D, Merrillville, IN 46410-6361 | 2016-09-14 |
| 1467907907 | Physical Medicine and Rehabilitation | Clinic/Center | 1146 Washington Sq, Evansville, IN 47715-6809 | 2016-08-24 |
| Find all providers with the same taxonomy | ||||
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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.