Provider Demographics
NPI:1922020288
Name:COX, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:765-298-5280
Mailing Address - Fax:765-552-3351
Practice Address - Street 1:1515 S 19TH ST
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IN
Practice Address - Zip Code:46036-2941
Practice Address - Country:US
Practice Address - Phone:765-298-2800
Practice Address - Fax:765-298-2820
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055131A207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01018451OtherRR MEDICARE
IN000000318436OtherANTHEM
INP00142511OtherRR MEDICARE
IN200440280Medicaid
INH87407Medicare UPIN
INP01018451OtherRR MEDICARE
IN200440280Medicaid
IN214510AMedicare PIN
IN940240A6Medicare PIN