Healthcare Provider Details

I. General information

NPI: 1154003689
Provider Name (Legal Business Name): SIMPLIFED MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 RIVER CROSSING PKWY STE 100
INDIANAPOLIS IN
46240-7766
US

IV. Provider business mailing address

9615 E COUNTY LINE RD STE B
CENTENNIAL CO
80112-3531
US

V. Phone/Fax

Practice location:
  • Phone: 888-458-1364
  • Fax:
Mailing address:
  • Phone: 888-991-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDREA IPPOLITO
Title or Position: CEO
Credential:
Phone: 339-234-0164