CENTRAL INDIANA MEDICAL GROUP – NPI #1720277544
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

CENTRAL INDIANA MEDICAL GROUP is a provider located in INDIANAPOLIS, IN. NPPES has assigned the NPI number 1720277544 to CENTRAL INDIANA MEDICAL GROUP on October 17, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CENTRAL INDIANA MEDICAL GROUP” is a dba name, the actual legal business name for this organization is GRAND OLD DOCS OF THE SOUTHSIDE. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 18 years ago on Jun 27, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CENTRAL INDIANA MEDICAL GROUP below.

NPI Profile for
GRAND OLD DOCS OF THE SOUTHSIDE

NPI Number
1720277544
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRAND OLD DOCS OF THE SOUTHSIDE
Doing Business As (dba): CENTRAL INDIANA MEDICAL GROUP
Primary location
8920 SOUTHPOINTE DR
SUITE E-1
INDIANAPOLIS, IN 46227-7509
Phone: (317) 882-0535 Fax: (317) 882-0173
Mailing address
1350 E COUNTY LINE RD
SUITE I
INDIANAPOLIS, IN 46227-0873
Phone: (317) 882-0535 Fax: (317) 882-0173
Organization Subpart
No
Authorized Official
ROBERT DICKS
MD/OWNER
Phone: (317) 882-0535
Updated
Identifiers

Identifiers for CENTRAL INDIANA MEDICAL GROUP

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERGROUP RR MCE #INCI4722
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)		 IN 01022713A

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.