INDYDERM LLC (NPI# 1497105191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497105191 |
| Entity Type | Organization |
| Organization Name | INDYDERM LLC |
| Practice Address |
8936 Southpointe Dr Suite B2 Indianapolis IN 46227-7507 |
| Practice Telephone | 3172150928 |
| Practice Fax Number | 3177438148 |
| Mailing Telephone | 3172150928 |
| Mailing Fax Number | 3177438148 |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-12-07 |
| Authorized Official Name | EMILY KELLER (OWNER) |
| Authorized Official Telephone | 3172150928 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
01072313A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 08029326 | 05 |
| Street Address |
8936 SOUTHPOINTE DR SUITE B2 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46227-7507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578530093 | Stacy A. Bierce | Physical Therapist | 8936 Southpointe Dr, Suite A-1, Indianapolis, IN 46227-7507 | 2006-03-02 |
| 1124550025 | Kevin Hagemeier | Prosthetic/Orthotic Supplier | 8936 Southpointe Dr, Suite B-1, Indianapolis, IN 46227-7507 | 2017-03-30 |
| 1902156532 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 8936 Southpointe Dr, Suite B-1, Indianapolis, IN 46227-7507 | 2012-09-11 |
| 1558632273 | Shradha Choudhary | Physical Therapist | 8936 Southpointe Dr, Suite A-1, Indianapolis, IN 46227-7507 | 2012-01-26 |
| 1790928497 | Emily Catherine Keller | Dermatology | 8936 Southpointe Dr, Suite B2, Indianapolis, IN 46227-7507 | 2009-04-09 |
| 1033242367 | Moody Eyes LLC | Optometrist | 8936 Southpointe Dr, Suite C-5, Indianapolis, IN 46227-7507 | 2007-03-14 |
| 1326170564 | Michelle Lumsdon | Dentist | 8936 Southpointe Dr, Suite B 6 Choice Dental Centre of Greenwood PC, Indianapolis, IN 46227-7506 | 2007-03-12 |
| 1952369282 | D Penn Moody | Optometrist | 8936 Southpointe Dr, Suite C-5, Indianapolis, IN 46227-7507 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679184477 | Zachry Skinner | Specialist/Technologist | 1683 E Hanna Ave, Indianapolis, IN 46227 | 2020-08-14 |
| 1104481415 | Corinne Mcdonald | Music Therapist | 7502 Madison Avenue, Indianapolis, IN 46227 | 2019-05-02 |
| 1205318649 | Kesha Conner | Counselor | 8320 Madison Ave Indianapolis, In, Indianapolis, IN 46227 | 2018-09-01 |
| 1609369719 | Victoria Lynn West Arnold | Physician Assistant | 1550 E County Line Rd Ste 320, Indianapolis, IN 46227 | 2018-06-13 |
| 1518466960 | Debra Cottongim | Physical Therapy Assistant | 6329 South East St, Ste A, Indianapolis, IN 46227 | 2018-02-12 |
| 1962943019 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6826 Madison Ave, Indianapolis, IN 46227 | 2017-03-09 |
| 1205386687 | Kylie Rochelle Bontrager | Dentist | 3658 East Street, Indianapolis, IN 46227 | 2016-10-10 |
| 1013371137 | Kayla Ford | Occupational Therapist | 3230 Rue Chanel, Apt 162, Indianapolis, IN 46227 | 2016-04-06 |
| 1639551344 | Sara Allyn Shrivastav | Technician, Other | 3711 E Southport Rd, Indianapolis, IN 46227 | 2015-06-18 |
| 1598146565 | Theodore Christian Seger | Family Medicine | 610 E Southport Rd Ste 205, Indianapolis, IN 46227 | 2015-06-15 |
| Find all providers in zip 46227 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790928497 | Emily Catherine Keller | Dermatology | 8936 Southpointe Dr, Suite B2, Indianapolis, IN 46227-7507 | 2009-04-09 |
| 1659443471 | Robert M Hurwitz | Dermatology | 9292 N Meridian St, Suite 210, Indianapolis, IN 46260-1828 | 2006-11-15 |
| 1710068796 | Ingrida Iveta Ozols | Dermatology | 6820 Parkdale Place, Suite 211, Indianapolis, IN 46254-6600 | 2006-10-18 |
| 1306933858 | Mary Coffey Greist | Dermatology | 6820 Parkdale Place, Suite 211, Indianapolis, IN 46254-6600 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467644344 | L. J. Buckel Md Inc | Dermatology | 53 S Park Blvd, Greenwood, IN 46143-8839 | 2007-08-14 |
| 1811090939 | Larry J Buckel | Dermatology | 53 South Park Blvd, Greenwood, IN 46143 | 2006-09-06 |
| 1609169671 | Dermatology Center of Northwest Indiana LLC | Dermatology | 70 W 94th Pl, Crown Point, IN 46307-1710 | 2011-05-24 |
| 1013923119 | Gary P Dillon | Dermatology | 1500 Salem St, Lafayette, IN 47904-2164 | 2006-07-31 |
| City | INDIANAPOLIS |
| Zip Code | 46227 |
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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.