NEUROTECH, LLC (NPI# 1790199859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790199859 |
| Entity Type | Organization |
| Organization Name | NEUROTECH, LLC |
| Other Organization Name | NEUROTECH INDIANA |
| Practice Address |
8555 Cedar Place Dr Suite 113-a Indianapolis IN 46240-8305 |
| Mailing Address |
626 W Moreland Blvd Waukesha WI 53188-2433 |
| Practice Telephone | 3177352562 |
| Mailing Telephone | 2627540898 |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2019-03-09 |
| Authorized Official Name | KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING & RESEARCH) |
| Authorized Official Telephone | 2628756572 |
| Is Organization Subpart | Y |
| Parent Organization Name | NEUROTECH, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers | ||
| N | 2472E0500X |
Technician, Other Specialization: EEG |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201132380A | 05 |
| Other Name | Type Code |
|---|---|
| Neurotech Indiana | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912560772 | Neurotech, LLC | Specialist/Technologist, Other | 117 Ne Trilein Dr Ste 202, Ankeny, IA 50021-2082 | 2019-04-17 |
| 1245793447 | Neurotech, LLC | Specialist/Technologist, Other | 90 Court St Ste 211b, Middletown, CT 06457-3334 | 2019-04-13 |
| 1194283341 | Neurotech, LLC | Technician, Other | 1440 Rockside Rd Ste 315, Parma, OH 44134-2749 | 2019-03-06 |
| 1194289603 | Neurotech, LLC | Technician, Other | 2120 44th St Se Ste 202, Kentwood, MI 49508-5321 | 2019-01-29 |
| 1811451925 | Neurotech, LLC | Technician, Other | 520 Grand Central Ave Unit 204-b, Vienna, WV 26105-2187 | 2019-01-23 |
| 1891259065 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St, Aurora, IL 60504-4590 | 2019-01-22 |
| 1265903710 | Neurotech, LLC | Technician, Other | 2255 W Laskey Rd Ste A-2, Toledo, OH 43613-3573 | 2018-12-10 |
| 1447735451 | Neurotech, LLC | Specialist/Technologist, Other | 1820 Ridge Rd Ste 303a, Homewood, IL 60430-1759 | 2018-09-26 |
| 1942795190 | Neurotech, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1263 Main St Ste 213, Green Bay, WI 54302-1341 | 2018-06-28 |
| 1649763756 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St Ste 105, Aurora, IL 60504-4589 | 2018-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Neurotech, LLC | 626 W. Moreland Blvd, Waukesha, WI 53188 |
| System for Award Management (SAM) Entities | NEUROTECH, LLC | 626 W Moreland Blvd, Waukesha, WI 53188-2433 |
| Washington State Corporations | NEUROTECH, LLC | 2510 N Pines Rd, Suite 5, Spokane Vly, WA 99206-7636 |
| Street Address |
8555 CEDAR PLACE DR SUITE 113-A |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46240-8305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720231673 | John Clarence Ehrmann Jr. | Psychologist | 8555 Cedar Place Dr, Suite 113a, Indianapolis, IN 46240-8305 | 2008-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124674908 | Indianapolis Neurobehavioral Health Center LLC | Psychologist | 921 E. 86th St., Suite 210 C, Indianapolis, IN 46240 | 2019-08-16 |
| 1720507999 | Refractive Surgery Professionals LLC | Clinic/Center | 8500 Keystone Xing Ste 150, Indianapolis, IN 46240 | 2017-09-19 |
| 1184148892 | Hannah Hoyt | Specialist/Technologist | 9504 N. Washington Blvd, Indianapolis, IN 46240 | 2017-08-03 |
| 1134657455 | Donann Kissick | Speech-Language Pathologist | 450 E 96th St., Suite 500, Indianapolis, IN 46240 | 2017-05-31 |
| 1992138804 | George Byington Pratt IIi | Radiology | 9015 Crystal Lake Drive, Indianapolis, IN 46240 | 2013-08-14 |
| 1871934513 | Kayla Harpenau | Occupational Therapist | 7405 Westfield Blvd, Indianapolis, IN 46240 | 2013-07-10 |
| 1235483835 | Christina Marie Wilson | Nurse Practitioner | 8888 Keystone Crossing, Suite 1300, Indianapolis, IN 46240 | 2012-11-04 |
| 1770850927 | Holly Bergeron | Pharmacist | 1505 E 86th Street, Indianapolis, IN 46240 | 2011-11-16 |
| 1104128214 | Meghan Kyle Fricke | Physician Assistant | 860 E 86th St Ste 4, Indianapolis, IN 46240 | 2010-11-22 |
| 1689901118 | Katherine Jane Russell | Audiologist | 2001 W. 86th St., Indianapolis, IN 46240 | 2009-11-04 |
| Find all providers in zip 46240 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356891568 | Lifetime Imaging LLC | Physiological Laboratory | 5144 E Stop 11 Road, Suite 18, Indianapolis, IN 46237-8606 | 2016-10-12 |
| 1235507773 | Community Imaging Associates, LLC | Physiological Laboratory | 10122 E 10th St Ste 101, Indianapolis, IN 46229-3046 | 2015-09-14 |
| 1376700088 | Medical Diagnostic Services Inc | Physiological Laboratory | Medical Diagnostic Services Inc, 8007 S Meridian St, Indianapolis, IN 46217-2901 | 2008-05-20 |
| 1831790864 | My Mobile Diagnostics Idtf LLC | Physiological Laboratory | 429 E Vermont St Ste 110, Indianapolis, IN 46202-3685 | 2020-11-05 |
| 1275502692 | Insight Health Corp | Physiological Laboratory | 8849 Shelby St, Ste B1, Indianapolis, IN 46227-7508 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730717331 | St Marys Health Inc | Physiological Laboratory | 100 St Marys Epworth Xing # C100, Newburgh, IN 47630-9497 | 2020-03-30 |
| 1720555170 | St. Vincent Medical Group, Inc. | Physiological Laboratory | 1300 Innovation Parkway, #150, Greenwood, IN 46143-3625 | 2018-10-24 |
| 1588032023 | Community Imaging Associates, LLC | Physiological Laboratory | 13121 Olio Rd Ste 120, Fishers, IN 46037-7240 | 2015-09-14 |
| 1225406770 | Community Imaging Associates, LLC | Physiological Laboratory | 11911 N Meridian St Ste 175, Carmel, IN 46032-6944 | 2015-09-14 |
| 1962421172 | Indiana Ultrasound Diagnostics | Physiological Laboratory | 205 E Carmel Dr, Carmel, IN 46032-2606 | 2006-07-19 |
| 1619916954 | Imaging Center of North Central Indiana, Inc. | Physiological Laboratory | 2201 West Blvd., Kokomo, IN 46902 | 2006-06-05 |
| 1548239973 | Insight Health Corp. | Physiological Laboratory | 590 Missouri Ave, Ste 200, Clarksville, IN 47129-0000 | 2006-03-16 |
| 1114923976 | Isis Medical, Incorporated | Physiological Laboratory | 119 Garwood Rd, Richmond, IN 47374-6031 | 2005-06-24 |
| 1134696099 | Hancock Health Gateway Services, Inc. | Physiological Laboratory | 6189 W. John L. Modglin Dr., Suite 103, Greenfield, IN 46140-9364 | 2018-10-30 |
| 1851842496 | St. Mary's Health, Inc | Physiological Laboratory | 14020 Old State Rd, Suite A300, Evansville, IN 47725-1164 | 2016-10-19 |
| Find all providers with the same taxonomy | ||||
| City | INDIANAPOLIS |
| Zip Code | 46240 |
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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.