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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ALTUS DIRECT, LLC
NPI 1750829230
Family Medicine in Greenwood, IN

Active since February 06, 2017CLIA 15D2126074 · Waiver
1040 GREENWOOD SPRINGS BLVD, STE 1A, GREENWOOD, IN 46143(317) 300-7424(317) 360-6245 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 17, 2026, Oct 9, 2023, Feb 7, 2017 (3 updates tracked since 2017).

About Altus Direct, Llc NPPES

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

ALTUS DIRECT, LLC (NPI 1750829230), doing business as Supro Direct, is a healthcare organization registered as a family medicine in Greenwood, Indiana and active in the NPI registry since February 2017. The organization holds a CLIA Waiver certificate valid through February 19, 2027 and lists Praveen Rajanahalli, Tin Owner, as its authorized official.

NPPES Registry Identity

NPI1750829230
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameALTUS DIRECT, LLC
Location Address1040 GREENWOOD SPRINGS BLVD, STE 1AGreenwood, IN 46143
Mailing Address1040 Greenwood Springs Blvd, Ste 1aGreenwood, IN 46143 · (317) 300-7424 · Fax (317) 360-6245
Phone(317) 300-7424
Fax(317) 360-6245
Organization SubpartNo
Authorized OfficialPraveen RajanahalliTin Owner · (317) 300-7424
Enumeration DateFebruary 6, 2017
Last NPPES UpdateSeptember 17, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2026
✔ NPI 1750829230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
1040 GREENWOOD SPRINGS BLVD, Greenwood, IN 46143
Open in Google Maps ↗

Other Names 1

Doing Business AsSupro Direct

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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 15D2126074

Supro Direct · Greenwood, IN
Active · expires Feb 19, 2027
CLIA Number15D2126074
Laboratory TypePhysician Office
Certificate Effective DateFebruary 20, 2025
Certificate Expiration DateFebruary 19, 2027
Laboratory DirectorPraveen Rajanahalli
Laboratory Phone(317) 300-7424
Laboratory LocationSupro Direct701 E County Line Rd Ste 210, Greenwood, IN 46143
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

JAN WISSEL NP
Nurse Practitioner
1040 GREENWOOD SPRINGS BLVD
GREENWOOD, IN 46143
Johnson County (317) 893-0888
SOUTHSIDE PULMONARY & SLEEP CONSULTANTS, LLC
Internal Medicine (Pulmonary Disease)
1040 GREENWOOD SPRINGS BLVD
GREENWOOD, IN 46143
Johnson County (317) 893-0888

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 Altus Direct, LLC's NPI number?

The NPI number for Altus Direct, LLC is 1750829230. It was assigned to this organization in the NPPES registry on February 6, 2017. The provider is doing business as Supro Direct.

Where is Altus Direct, LLC located?

Altus Direct, LLC is located at 1040 Greenwood Springs Blvd Ste 1A, Greenwood, IN 46143. The listed phone number is (317) 300-7424.

What is Altus Direct, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Altus Direct, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2126074) is associated with this NPI, valid through February 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Altus Direct, LLC accept?

Health plans from CareSource list Altus Direct, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Altus Direct, LLC was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.