ENVISION DIAGNOSTIC SERVICES
NPI 1457015752
Nurse Practitioner - Family in Indianapolis, IN
About Envision Diagnostic Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ENVISION DIAGNOSTIC SERVICES (NPI 1457015752) is a healthcare organization registered as a family in Indianapolis, Indiana and active in the NPI registry since October 2021. The organization lists Chanel Jones, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Envision Diagnostic Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
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 Envision Diagnostic Services's NPI number?
The NPI number for Envision Diagnostic Services is 1457015752. It was assigned to this organization in the NPPES registry on October 24, 2021.
Where is Envision Diagnostic Services located?
Envision Diagnostic Services is located at 4916 Birmingham Dr, Indianapolis, IN 46235. The listed phone number is (260) 312-6305.
What is Envision Diagnostic Services's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Envision Diagnostic Services enrolled in Medicare?
Yes. Envision Diagnostic Services is registered in the Medicare PECOS enrollment system.
When is Envision Diagnostic Services's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Mass Immunization (Roster Biller Only)) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
When was this NPI record last updated?
The NPPES record for Envision Diagnostic Services was last updated on October 24, 2021. 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.
# Envision Diagnostic Services · NPI 1457015752
Family organization in Indianapolis, Indiana. Organization record, active in the CMS NPPES registry since October 24, 2021.
## Identity
- **NPI:** 1457015752 (Entity type: Organization)
- **Enumerated:** October 24, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Chanel Jones, OWNER
## Practice location
- **Address:** 4916 BIRMINGHAM DR, Indianapolis, IN 46235-6103
- **Phone:** (260) 312-6305
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Indiana, Mass Immunization (Roster Biller Only)) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** October 24, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1457015752) · Data from the CMS NPPES public registry.