Emerald Neuro-recover | |
12265 Hancock St Ste 42 Carmel IN 46032-5801 | |
(317) 606-8778 | |
(317) 740-0534 |
Full Name | Emerald Neuro-recover |
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Speciality | Family Medicine |
Location | 12265 Hancock St Ste 42, Carmel, Indiana |
Authorized Official Name and Position | Margaret G Dunteman (BILLING AGENT) |
Authorized Official Contact | 6307703800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Emerald Neuro-recover 12265 Hancock St Ste 42 Carmel IN 46032-5801 Ph: (317) 606-8778 | Emerald Neuro-recover 12265 Hancock St Ste 42 Carmel IN 46032-5801 Ph: (317) 606-8778 |
NPI Number | 1508334814 |
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Provider Enumeration Date | 11/05/2018 |
Last Update Date | 09/25/2019 |
Medicare PECOS PAC ID | 1052740081 |
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Medicare Enrollment ID | O20200326002100 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508334814 | NPI | - | NPPES |
200216290 | Medicaid | IN | |
2617421 | Medicaid | OH | |
000000380603 | Other | IN | ANTHEM |
104874712 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Jessica Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982084687 PECOS PAC ID: 2365749637 Enrollment ID: I20160331001427 |
Provider Name | John E Humiston |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1841507605 PECOS PAC ID: 0143481754 Enrollment ID: I20200420000871 |
Provider Name | Arthur W Adams |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1659989572 PECOS PAC ID: 5890102560 Enrollment ID: I20210324001820 |
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