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ASCENSION MEDICAL GROUP ST. VINCENT
NPI 1720555170
Physiological Laboratory in Greenwood, IN

Active since October 24, 2018CLIA 15D2157269 · Waiver
1300 INNOVATION PARKWAY, #150, GREENWOOD, IN 46143(317) 583-4410 Get Directions Write a Review

NPPES record last updated: February 12, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 12, 2020, Feb 6, 2020, Oct 24, 2018 (3 updates tracked since 2018).

About Ascension Medical Group St. Vincent NPPES

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

ASCENSION MEDICAL GROUP ST. VINCENT (NPI 1720555170) is a healthcare organization registered as a physiological laboratory in Greenwood, Indiana and active in the NPI registry since October 2018. The organization holds a CLIA Waiver certificate valid through May 29, 2027 and lists Brian Morris, Cfo, as its authorized official.

NPPES Registry Identity

NPI1720555170
Entity TypeOrganization
Primary Taxonomy293D00000X
Legal Business NameST. VINCENT MEDICAL GROUP, INC.
Location Address1300 INNOVATION PARKWAY, #150Greenwood, IN 46143-3625
Mailing Address250 W 96th St # 520Indianapolis, IN 46260-1316
Phone(317) 583-4410
Organization SubpartNo
Authorized OfficialBrian MorrisCfo · (317) 338-6234
Enumeration DateOctober 24, 2018
Last NPPES UpdateFebruary 12, 20203 updates tracked since enumeration
✔ NPI 1720555170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysiological LaboratoryLaboratories
Taxonomy Code293D00000X
Definition
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
1300 INNOVATION PARKWAY, Greenwood, IN 46143
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Other Names 1

Doing Business AsAscension Medical Group St. Vincent

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 15D2157269

Ascension Medical Group St Vincent-Greenwood Primary, Specialty Care & Walk-In Clinic · Greenwood, IN
Active · expires May 29, 2027
CLIA Number15D2157269
Laboratory TypePhysician Office
Certificate Effective DateMay 30, 2025
Certificate Expiration DateMay 29, 2027
Laboratory DirectorDattaben Pandya
Laboratory Phone(317) 879-4800
Laboratory LocationAscension Medical Group St Vincent-Greenwood Primary, Specialty Care & Walk-In Clinic1579 Olive Branch Parke Lane, Suite 180, Greenwood, IN 46143
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 St. Vincent Medical Group, Inc.'s NPI number?

The NPI number for St. Vincent Medical Group, Inc. is 1720555170. It was assigned to this organization in the NPPES registry on October 24, 2018. The provider is doing business as Ascension Medical Group St. Vincent.

Where is St. Vincent Medical Group, Inc. located?

St. Vincent Medical Group, Inc. is located at 1300 Innovation Parkway #150, Greenwood, IN 46143. The listed phone number is (317) 583-4410.

What is St. Vincent Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Physiological Laboratory with taxonomy code 293D00000X.

Does St. Vincent Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2157269) is associated with this NPI, valid through May 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St. Vincent Medical Group, Inc. was last updated on February 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.