1811772163 NPI number — INTEGRATED PATIENT SOLUTIONS OF INDIANA, PC

Table of content: (NPI 1811772163)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811772163 NPI number — INTEGRATED PATIENT SOLUTIONS OF INDIANA, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRATED PATIENT SOLUTIONS OF INDIANA, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811772163
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1125 17TH ST, STE 1000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80202-3113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-204-5760
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 45TH ST STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHLAND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46322-3277
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-998-7337
Provider Business Practice Location Address Fax Number:
844-465-6341
Provider Enumeration Date:
08/25/2023

Additional Information

Authorized Official

Authorized Official Last Name:
SILVER
Authorized Official First Name:
ALLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP, CENTRAL OPS
Authorized Official Telephone Number:
404-408-5442

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com