EAGLE CREEK DERMATOLOGY
NPI 1053561928
Dermatology - Clinical & Laboratory Dermatological Immunology in Indianapolis, IN
NPI Status: Active since September 26, 2008
Contact Information
6820 PARKDALE PL
SUITE 211
INDIANAPOLIS, IN
ZIP 46254
Phone: (317) 329-7050
Fax: (317) 328-6809
- Organization
- Dermatology
- Clinical & Laboratory Dermatological Imm...
- CLIA Number: 15D0687550
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-02-2028
About EAGLE CREEK DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Eagle Creek Dermatology, a provider established in Indianapolis, Indiana operating as a Dermatology, focusing in clinical & laboratory dermatological immunology . The healthcare provider is registered in the NPI registry with number 1053561928 assigned on September 2008. The practitioner's primary taxonomy code is 207NI0002X with license number 01024873 (IN). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Ingrida Iveta Ozols Md (Partner)
- NPI
- 1053561928
- Provider Name
- EAGLE CREEK DERMATOLOGY
- Entity Type
- Organization
- Location Address
- 6820 PARKDALE PL SUITE 211 INDIANAPOLIS, IN 46254
- Location Phone
- (317) 329-7050
- Location Fax
- (317) 328-6809
- Mailing Address
- 6820 PARKDALE PL SUITE 211 INDIANAPOLIS, IN 46254
- Mailing Phone
- (317) 329-7050
- Mailing Fax
- (317) 328-6809
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-26-2008
- Last Update Date
- 09-11-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology Clinical & Laboratory Dermatological Immunology
- Taxonomy Code
- 207NI0002X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01024873
- License State
- IN
- Taxonomy Description
- A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | 01027554 (IN) |
| 2 | 207NI0002X | Allopathic & Osteopathic Physicians | Dermatology | 01057248 (IN) |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D0687550
- Facility Type
- Physician Office
- Certificate Effective Date
- January 03, 2026
- Certificate Expiration Date
- January 02, 2028
- Laboratory Director
- INGRIDA I. OZOLS
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Eagle Creek Dermatology in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1053561928, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
INDIANAPOLIS, IN 46254
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053561928, enumerated as an "organization" on September 26, 2008.
The provider is located at 6820 PARKDALE PL SUITE 211 INDIANAPOLIS, IN 46254 and the phone number is (317) 329-7050.
Dermatology with taxonomy code 207NI0002X and a focus in Clinical & Laboratory Dermatological Immunology.
