Healthcare Provider Details

I. General information

NPI: 1871418517
Provider Name (Legal Business Name): WEBSTER DIRECT PRIMARY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 E 86TH ST
INDIANAPOLIS IN
46240-1803
US

IV. Provider business mailing address

727 E 86TH ST
INDIANAPOLIS IN
46240-1803
US

V. Phone/Fax

Practice location:
  • Phone: 317-296-4224
  • Fax:
Mailing address:
  • Phone: 317-296-4224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATHANIEL JOHN WEBSTER
Title or Position: CEO
Credential: NP
Phone: 978-821-3872