INDIANA SPINE AND PAIN CENTER INC (NPI# 1265644397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265644397 |
| Entity Type | Organization |
| Organization Name | INDIANA SPINE AND PAIN CENTER INC |
| Other Organization Name | INDIANA LASER SPINE CENTER INC |
| Practice Address |
8202 Clearvista Parkway Suite 9 E Indianapolis IN 46256-1457 |
| Practice Telephone | 3175771800 |
| Practice Fax Number | 3175771805 |
| Mailing Telephone | 3175771800 |
| Mailing Fax Number | 3175771805 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-02-08 |
| Authorized Official Name | DR. PHILLIP R. KINGMA (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 3175771800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
01040487 | IN | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
01040487A | IN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Indiana Laser Spine Center Inc | Former Legal Business Name - Organization |
| Street Address |
8202 CLEARVISTA PARKWAY SUITE 9 E |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46256-1457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659311959 | Sarah D Curry | Family Medicine | 8202 Clearvista Parkway, Suite 6b, Indianapolis, IN 46256-1442 | 2006-06-07 |
| 1134427875 | Dreams In Motion, Inc. | Speech-Language Pathologist | 8202 Clearvista Parkway, Suite 8f, Indianapolis, IN 46256 | 2011-03-04 |
| 1497086136 | Dowden Speech Therapy, Inc. | Behavioral Analyst | 8202 Clearvista Parkway, Suite 8f, Indianapolis, IN 46256 | 2010-01-20 |
| 1962679068 | Methee Srivatana | Internal Medicine | 8202 Clearvista Parkway, Suite 8, Indianapolis, IN 46256-1456 | 2008-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790316859 | Jacob R Weeks | Behavior Technician | 9769 Crosspointed Blvd, Fishers, IN 46256 | 2020-01-28 |
| 1780236620 | Amare Hospice & Palliative Care | Family Medicine | 10475 Crosspoint Boulevard, Suite 250, Indianapolis, IN 46256 | 2019-07-11 |
| 1588226864 | Accutreat LLC | Clinical Medical Laboratory | 9661 Crosspoint Blvd, Indianapolis, IN 46256 | 2019-07-08 |
| 1447732557 | Kathleen O'hara | Marriage & Family Therapist | 8202 Clearvista Pkwy Unit 7, Indianapolis, IN 46256 | 2018-09-05 |
| 1205313608 | Healing Bridges Counseling, LLC | Marriage & Family Therapist | 8465 Keystone Crossing, Suite 266, Indianapolis, IN 46256 | 2018-07-27 |
| 1477062123 | Rosalee Ann Miller | Social Worker | 8202 Clearvista Parkway, Suite 6a, Indianapolis, IN 46256 | 2017-09-26 |
| 1760900039 | Amye Litherland | Registered Nurse | 7525 E. 82nd St Ste A, Indianapolis, IN 46256 | 2017-09-06 |
| 1275074239 | Jason Dempsey | Hearing Instrument Specialist | 8202 Clearvista Pkwy 3a, Indianapolis, IN 46256 | 2017-03-10 |
| 1578922761 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 7155 Shadeland Station Way, Suite 130, Indianapolis, IN 46256 | 2016-02-16 |
| 1477925071 | Samantha Kitcoff | Physician Assistant | 8180 Clearvista Pkwy Ste 100, Indianapolis, IN 46256 | 2015-10-22 |
| Find all providers in zip 46256 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654070 | Providence Medical Associates LLC | Clinic/Center | 1935 N Capitol Ave Ste 107, Indianapolis, IN 46202-6403 | 2020-09-18 |
| 1306222757 | Midwest Wellness LLC | Clinic/Center | 6822 E 82nd St Ste 310, Indianapolis, IN 46250-1677 | 2015-08-08 |
| 1861757023 | Integrative Therapeutics LLC | Clinic/Center | 11074 Woods Bay Ln, Indianapolis, IN 46236-9020 | 2012-07-12 |
| 1609079607 | Jeffrey D. Wagner, Md, PC | Clinic/Center | 8040 Clearvista Pkwy Ste 570, Indianapolis, IN 46256-4673 | 2007-06-07 |
| 1457736811 | Ace Medical Services | Clinic/Center | 855 N High School Rd, Suite 5, Indianapolis, IN 46214-5701 | 2015-07-28 |
| 1679916001 | Integrated Medical Care and Nephrology LLC | Clinic/Center | 6925 Shore Ter, Indianapolis, IN 46254-4675 | 2013-04-16 |
| 1043500010 | Franciscan Saint Francis Hospitals and Health Centers | Clinic/Center | 5230 E Stop 11 Rd Ste A, Indianapolis, IN 46237-6339 | 2011-04-12 |
| 1801116223 | Neurological Care of Indiana Inc | Clinic/Center | 3500 Depauw Blvd Ste 2082, Indianapolis, IN 46268-1137 | 2010-06-08 |
| 1881875540 | Indiana Center for Health and Nutrition | Clinic/Center | 7440 N Shadeland Ave, Suite 206, Indianapolis, IN 46250-2029 | 2007-11-21 |
| 1770706160 | Aba Programming Inc. | Clinic/Center | 7901 E 88th St, Indianapolis, IN 46256-1235 | 2007-04-11 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46256 |
Please comment or provide details below to improve the information on INDIANA SPINE AND PAIN CENTER INC.
| 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.