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PROVIDENCE MEDICAL ASSOCIATES LLC
NPI 1326654070
Clinic/Center - Medical Specialty in Indianapolis, IN

Active since September 18, 2020
1935 N CAPITOL AVE STE 107, INDIANAPOLIS, IN 46202(716) 686-2104 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 22, 2020, Sep 18, 2020 (2 updates tracked since 2020).

About Providence Medical Associates Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE MEDICAL ASSOCIATES LLC (NPI 1326654070) is a healthcare organization registered as a medical specialty in Indianapolis, Indiana and active in the NPI registry since September 2020. The organization lists Olufunke Louise Brimmo-longe, Owner, as its authorized official.

NPPES Registry Identity

NPI1326654070
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NamePROVIDENCE MEDICAL ASSOCIATES LLC
Location Address1935 N CAPITOL AVE STE 107Indianapolis, IN 46202-6403
Mailing Address4000 W 106th St Ste 125-207Carmel, IN 46032-7720
Phone(716) 686-2104
Organization SubpartNo
Authorized OfficialOlufunke Louise Brimmo-longeOwner · (716) 686-2104
Enumeration DateSeptember 18, 2020
Last NPPES UpdateOctober 22, 20202 updates tracked since enumeration
NPPES CertifiedOctober 22, 2020
✔ NPI 1326654070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
1935 N CAPITOL AVE STE 107, Indianapolis, IN 46202
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Medical Associates LLC's NPI number?

The NPI number for Providence Medical Associates LLC is 1326654070. It was assigned to this organization in the NPPES registry on September 18, 2020.

Where is Providence Medical Associates LLC located?

Providence Medical Associates LLC is located at 1935 N Capitol Ave Ste 107, Indianapolis, IN 46202. The listed phone number is (716) 686-2104.

What is Providence Medical Associates LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Providence Medical Associates LLC was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.