Healthcare Provider Details

I. General information

NPI: 1871792150
Provider Name (Legal Business Name): BUILDING PEOPLE BUILDING COMMUNITY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3549 BOULEVARD PL
INDIANAPOLIS IN
46208-4403
US

IV. Provider business mailing address

3549 BOULEVARD PL
INDIANAPOLIS IN
46208-4403
US

V. Phone/Fax

Practice location:
  • Phone: 317-920-1300
  • Fax:
Mailing address:
  • Phone: 317-920-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28041546A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10000107A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01030481A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code246QL0901X
TaxonomyDiplomate Laboratory Management Specialist/Technologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01061519A
License Number StateIN

VIII. Authorized Official

Name: DR. PHILIP KARL JAMES
Title or Position: PRESIDENT OF ORGANIZATION
Credential: DM
Phone: 317-920-1300