| S4 Specialty Consultants Llc | |
|
900 N High School Rd Indianapolis IN 46214-3759 | |
| (615) 478-3720 | |
| Not Available |
| Full Name | S4 Specialty Consultants Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 900 N High School Rd, Indianapolis, Indiana |
| Authorized Official Name and Position | Jeremy T Sullivan (OWNER) |
| Authorized Official Contact | 6154783720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S4 Specialty Consultants Llc 2063 Finchley Rd Carmel IN 46032-7337 Ph: (615) 478-3720 | S4 Specialty Consultants Llc 900 N High School Rd Indianapolis IN 46214-3759 Ph: (615) 478-3720 |
| NPI Number | 1336884725 |
|---|---|
| Provider Enumeration Date | 05/01/2022 |
| Last Update Date | 05/01/2022 |
| Certification Date | 05/01/2022 |
| Medicare PECOS PAC ID | 4385011089 |
|---|---|
| Medicare Enrollment ID | O20221109003024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336884725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tina R Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962595223 PECOS PAC ID: 4385747054 Enrollment ID: I20070319000051 |
| Provider Name | Pamela Kinder Fountain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194955757 PECOS PAC ID: 3173651619 Enrollment ID: I20100504000806 |
| Provider Name | Rose C Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396080024 PECOS PAC ID: 7911152905 Enrollment ID: I20130222000358 |
| Provider Name | Tina R Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548626229 PECOS PAC ID: 6204130388 Enrollment ID: I20160210001354 |
| Provider Name | Lori Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679939987 PECOS PAC ID: 0648579086 Enrollment ID: I20160505002037 |
| Provider Name | Elizabeth A Mcquinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053780718 PECOS PAC ID: 7517276678 Enrollment ID: I20180322001326 |
| Provider Name | Ayee Bleemie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457975740 PECOS PAC ID: 6002238151 Enrollment ID: I20200619000349 |
| Provider Name | Leah Dawn Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386325587 PECOS PAC ID: 1153541057 Enrollment ID: I20231031001413 |
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