| Downtown Primary Care, LLC | |
|
950 N Alabama St Indianapolis IN 46202-3350 | |
| (317) 916-9946 | |
| (317) 916-9979 |
| Full Name | Downtown Primary Care, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 950 N Alabama St, Indianapolis, Indiana |
| Authorized Official Name and Position | Idella Nicole Simmons (PRESIDENT) |
| Authorized Official Contact | 3174142260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Downtown Primary Care, LLC 950 N Alabama St Indianapolis IN 46202-3350 Ph: (317) 414-2260 | Downtown Primary Care, LLC 950 N Alabama St Indianapolis IN 46202-3350 Ph: (317) 916-9946 |
| NPI Number | 1598531881 |
|---|---|
| Provider Enumeration Date | 11/28/2023 |
| Last Update Date | 11/28/2023 |
| Certification Date | 11/28/2023 |
| Medicare PECOS PAC ID | 4981049582 |
|---|---|
| Medicare Enrollment ID | O20240305000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598531881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Idella N Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912085879 PECOS PAC ID: 4183688781 Enrollment ID: I20041115000001 |
| Provider Name | Aundrianna Whiteside |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851923163 PECOS PAC ID: 5597140137 Enrollment ID: I20220916002391 |
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