Healthcare Provider Details

I. General information

NPI: 1215892294
Provider Name (Legal Business Name): CIRCLE CITY FOOT AND MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9075 CHOLLA RD
INDIANAPOLIS IN
46240-1932
US

IV. Provider business mailing address

9075 CHOLLA RD
INDIANAPOLIS IN
46240-1932
US

V. Phone/Fax

Practice location:
  • Phone: 317-269-7351
  • Fax:
Mailing address:
  • Phone: 317-269-7351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ROSALIE MOORE
Title or Position: NURSE PRACTIONER
Credential: AGPCNP
Phone: 317-372-6797