| Indiana Home Based Primary Care PC | |
|
11595 N Meridian St Ste 515 Carmel IN 46032-6969 | |
| (800) 807-6555 | |
| (855) 316-2999 |
| Full Name | Indiana Home Based Primary Care PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 11595 N Meridian St Ste 515, Carmel, Indiana |
| Authorized Official Name and Position | William Robert Mills (PRESIDENT) |
| Authorized Official Contact | 5023942100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana Home Based Primary Care PC 805 N Whittington Pkwy Ste 400 Louisville KY 40222-7102 Ph: (502) 394-2100 | Indiana Home Based Primary Care PC 11595 N Meridian St Ste 515 Carmel IN 46032-6969 Ph: (800) 807-6555 |
| NPI Number | 1578205548 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 11/11/2025 |
| Certification Date | 11/11/2025 |
| Medicare PECOS PAC ID | 7618358631 |
|---|---|
| Medicare Enrollment ID | O20220721001026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578205548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 253Z00000X | In Home Supportive Care | () | Secondary |
| Provider Name | Ruth Marie Poppele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851375364 PECOS PAC ID: 0345340477 Enrollment ID: I20070703000073 |
| Provider Name | Wauntesha Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518487677 PECOS PAC ID: 6507136918 Enrollment ID: I20170718001983 |
| Provider Name | Geana Terry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235592056 PECOS PAC ID: 6002114204 Enrollment ID: I20180808000862 |
| Provider Name | Shannon E Sitgreaves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750868568 PECOS PAC ID: 8325392749 Enrollment ID: I20181120003240 |
| Provider Name | Treana L Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952879603 PECOS PAC ID: 5496092777 Enrollment ID: I20190124000979 |
| Provider Name | Michele L Viers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639637341 PECOS PAC ID: 6709114127 Enrollment ID: I20190823000203 |
| Provider Name | Mary Wildeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790379618 PECOS PAC ID: 2365858479 Enrollment ID: I20210315001306 |
| Provider Name | Miranda Huffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376662833 PECOS PAC ID: 8325194590 Enrollment ID: I20220722000267 |
| Provider Name | Omar Ramos Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922594167 PECOS PAC ID: 9638427396 Enrollment ID: I20240201002125 |
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