| Integrative Health Specialist Of Indiana Pc | |
|
9333 N Meridian St Ste 202 Indianapolis IN 46260-1872 | |
| (317) 580-9333 | |
| (317) 818-8933 |
| Full Name | Integrative Health Specialist Of Indiana Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9333 N Meridian St, Indianapolis, Indiana |
| Authorized Official Name and Position | Kim Grider (BUSINESS ADMINISTRATOR) |
| Authorized Official Contact | 3177813604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Health Specialist Of Indiana Pc 9333 N Meridian St Ste 202 Indianapolis IN 46260-1872 Ph: (317) 580-9333 | Integrative Health Specialist Of Indiana Pc 9333 N Meridian St Ste 202 Indianapolis IN 46260-1872 Ph: (317) 580-9333 |
| NPI Number | 1689629511 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 06/25/2013 |
| Medicare PECOS PAC ID | 1153374111 |
|---|---|
| Medicare Enrollment ID | O20050302000268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689629511 | NPI | - | NPPES |
| 1629048715 | Other | IN | INDIVIDUAL NPI |
| 1619947710 | Other | IN | INDIVIDUAL NPI |
| 000000243460 | Other | IN | ANTHEM |
| 1558331652 | Other | IN | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rhonda J Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629048715 PECOS PAC ID: 8527040617 Enrollment ID: I20040602001514 |
| Provider Name | Sarah E Crook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730148768 PECOS PAC ID: 6507811767 Enrollment ID: I20050321000745 |
| Provider Name | Deanna L Kirk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225268519 PECOS PAC ID: 5294872362 Enrollment ID: I20091021000703 |
| Provider Name | Christina Lynn Dix Jackey |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003917774 PECOS PAC ID: 3173796331 Enrollment ID: I20111103000439 |
| Provider Name | Casi Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205369121 PECOS PAC ID: 8527309848 Enrollment ID: I20210618001151 |
| Provider Name | Macy Jane Louthain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295419281 PECOS PAC ID: 2769825215 Enrollment ID: I20240212002773 |
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