Healthcare Provider Details

I. General information

NPI: 1356566137
Provider Name (Legal Business Name): REHABILITATION PHYSICIANS OF INDIANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 SHORE DR
INDIANAPOLIS IN
46254-2607
US

IV. Provider business mailing address

4141 SHORE DR
INDIANAPOLIS IN
46254-2607
US

V. Phone/Fax

Practice location:
  • Phone: 317-329-2000
  • Fax:
Mailing address:
  • Phone: 317-329-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71000536A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number20010506A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number20041993A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number20041694A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001261A
License Number StateIN
# 6
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number01048577A
License Number StateIN

VIII. Authorized Official

Name: MR. DENNY ARMINGTON
Title or Position: CEO
Credential:
Phone: 317-329-2000