Provider Demographics
| NPI: | 1487680518 |
|---|---|
| Name: | UROLOGY OF INDIANA L.L.C. |
| Entity type: | Organization |
| Organization Name: | UROLOGY OF INDIANA L.L.C. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | M.D./ OWNER |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | BRADLEY |
| Authorized Official - Middle Name: | G |
| Authorized Official - Last Name: | ORRIS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 317-859-7222 |
| Mailing Address - Street 1: | 679 E COUNTY LINE RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GREENWOOD |
| Mailing Address - State: | IN |
| Mailing Address - Zip Code: | 46143-1049 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 317-885-1250 |
| Mailing Address - Fax: | 317-859-4268 |
| Practice Address - Street 1: | 679 E COUNTY LINE RD |
| Practice Address - Street 2: | |
| Practice Address - City: | GREENWOOD |
| Practice Address - State: | IN |
| Practice Address - Zip Code: | 46143-1049 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 317-859-7222 |
| Practice Address - Fax: | 317-859-7220 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-23 |
| Last Update Date: | 2021-03-17 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207VF0040X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | Group - Multi-Specialty |
| No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
| No | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | Group - Multi-Specialty |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| IN | 1003996638 | Other | DME LOCATION NPI |
| IN | 1104906734 | Other | DME LOCATION NPI |
| IN | 1205916830 | Other | DME LOCATION NPI |
| IN | 1669552295 | Other | DME LOCATION NPI |
| IN | 1275613804 | Other | DME LOCATION NPI |
| IN | 1932289568 | Other | DME LOCATION NPI |
| IN | 1225485899 | Other | UROPOINT LAB NPI |
| IN | 1447342894 | Other | DME LOCATION NPI |
| IN | 1487734018 | Other | DME LOCATION NPI |
| IN | 1740360379 | Other | DME LOCATION NPI |
| IN | 1902986532 | Other | DME LOCATION NPI |
| IN | 100194370 | Medicaid | |
| IN | 1548340177 | Other | DME LOCATION NPI |
| IN | 200288740 | Medicaid | |
| IN | 345000 | Medicare PIN | |
| IN | 1003996638 | Other | DME LOCATION NPI |
| IN | 069390 | Medicare PIN | |
| IN | 1205916830 | Other | DME LOCATION NPI |
| IN | 1234980014 | Medicare NSC | |
| IN | 1234980012 | Medicare NSC | |
| IN | 1234980007 | Medicare NSC | |
| IN | 1487734018 | Other | DME LOCATION NPI |
| IN | 1548340177 | Other | DME LOCATION NPI |
| IN | 200288740 | Medicaid | |
| IN | 1234980016 | Medicare NSC | |
| IN | 318870 | Medicare PIN | |
| IN | 1275613804 | Other | DME LOCATION NPI |
| IN | 1234980013 | Medicare NSC | |
| IN | 1234980001 | Medicare NSC | |
| IN | 160060 | Medicare PIN | |
| IN | 100194370 | Medicaid | |
| IN | 896480 | Medicare PIN | |
| IN | 069340 | Medicare PIN | |
| IN | 069350 | Medicare PIN | |
| IN | 1932289568 | Other | DME LOCATION NPI |
| IN | 1740360379 | Other | DME LOCATION NPI |
| IN | 677730 | Medicare PIN |