MEDICARE: ASPIRE INDIANA HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1346022761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRE INDIANA HEALTH INC

Provider Business Mailing Address
First Line	:	9615 E 148TH ST STE 1
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-4371
Country	:	US
Telephone Number	:	317-574-1254
Fax Number	:	317-674-0060

Provider Business Practice Location Address
First Line	:	201 SHELBY ST RM 101103
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-3943
Country	:	US
Telephone Number	:	317-574-1254
Fax Number	:	317-674-0060

Authorized Official
Title or Position	:	CFO
Name	:	TIMOTHY CROCKETT
Credential	:
Telephone Number	:	317-587-0505

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	12/31/2025

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