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CLOWN PEDIATRICS
NPI 1669674461
Specialist in Greenwood, IN

Active since June 04, 2007CLIA 15D1029507 · Waiver
401 CAMBY CT, GREENWOOD, IN 46142(317) 881-8737(317) 881-8735 Get Directions Write a Review

NPPES record last updated: May 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clown Pediatrics NPPES

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

CLOWN PEDIATRICS (NPI 1669674461) is a healthcare organization registered as a specialist in Greenwood, Indiana and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through August 17, 2026 and lists Jeremy Wade Roscoe, Physician, as its authorized official.

NPPES Registry Identity

NPI1669674461
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameCLOWN PEDIATRICS
Location Address401 CAMBY CTGreenwood, IN 46142-4085
Mailing Address401 Camby CtGreenwood, IN 46142-4085 · (317) 881-8737 · Fax (317) 881-8735
Phone(317) 881-8737
Fax(317) 881-8735
Organization SubpartNo
Authorized OfficialJeremy Wade RoscoePhysician · (317) 881-8737
Enumeration DateJune 4, 2007
Last NPPES UpdateMay 9, 2011
✔ NPI 1669674461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in IN · 1057187 A
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
401 CAMBY CT, Greenwood, IN 46142
Open in Google Maps ↗

Other Identifiers 1

Medicaid200479420 AIN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D1029507

Clown Pediatrics PC · Greenwood, IN
Active · expires Aug 17, 2026
CLIA Number15D1029507
Laboratory TypePhysician Office
Certificate Effective DateAugust 18, 2024
Certificate Expiration DateAugust 17, 2026
Laboratory DirectorDr. Jeremy W. Roscoe
Laboratory Phone(317) 881-8737
Laboratory LocationClown Pediatrics PC401 Camby Ct, Greenwood, IN 46142
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAITLYNN WORDEN
Nurse Practitioner (Pediatrics)
401 CAMBY CT
GREENWOOD, IN 46142
Johnson County (317) 881-8737
KATHRYN M MCGOVERN NP
Nurse Practitioner (Pediatrics)
401 CAMBY CT
GREENWOOD, IN 46142
Johnson County (317) 881-8737
DR. JEREMY WADE ROSCOE M.D.
Pediatrics
401 CAMBY CT
GREENWOOD, IN 46142
Johnson County (317) 881-8737
MR. STEPHEN CHRISTNER LMHC
Counselor (Mental Health)
401 CAMBY CT
GREENWOOD, IN 46142
Johnson County (317) 522-5748
ALISON O'BRIEN PNP-PC
Nurse Practitioner (Pediatrics)
401 CAMBY CT
GREENWOOD, IN 46142
Johnson County (317) 881-8737

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 Clown Pediatrics's NPI number?

The NPI number for Clown Pediatrics is 1669674461. It was assigned to this organization in the NPPES registry on June 4, 2007.

Where is Clown Pediatrics located?

Clown Pediatrics is located at 401 Camby Ct, Greenwood, IN 46142. The listed phone number is (317) 881-8737.

What is Clown Pediatrics's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Clown Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D1029507) is associated with this NPI, valid through August 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clown Pediatrics was last updated on May 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.