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CENTRAL INDIANA MEDICAL GROUP
NPI 1790886844
Family Medicine in Greenwood, IN

Active since September 25, 2006
360 S MADISON AVE, #200, GREENWOOD, IN 46142(317) 865-9090(317) 865-0523 Get Directions Write a Review

NPPES record last updated: June 30, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Central Indiana Medical Group NPPES

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

CENTRAL INDIANA MEDICAL GROUP (NPI 1790886844) is a healthcare organization registered as a family medicine in Greenwood, Indiana and active in the NPI registry since September 2006. The organization lists Brenda R Russell, Physician, as its authorized official.

NPPES Registry Identity

NPI1790886844
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGRAND OLD DOCS OF THE SOUTHSIDE
Location Address360 S MADISON AVE, #200Greenwood, IN 46142-3150
Mailing Address1350 E County Line Rd, Suite IIndianapolis, IN 46227-0873 · (317) 865-9090 · Fax (317) 865-0523
Phone(317) 865-9090
Fax(317) 865-0523
Organization SubpartNo
Authorized OfficialBrenda R RussellPhysician · (317) 865-9090
Enumeration DateSeptember 25, 2006
Last NPPES UpdateJune 30, 2008
✔ NPI 1790886844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
360 S MADISON AVE, Greenwood, IN 46142
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Other Names 1

Doing Business AsCentral Indiana Medical Group

Other Identifiers 3

Other5457630003IN · Dme
OtherCI4722IN · Group Rr Medicare Number
Medicare PIN132440IN

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

Other Providers at the Same Location NPPES 4

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

COMMUNITY HOSPITALS OF INDIANA INC
Family Medicine
360 S MADISON AVE, SUITE 100
GREENWOOD, IN 46142
Johnson County (317) 881-8248
GREENWOOD PHYSICIANS ASSOCIATES LLP
Family Medicine
360 S MADISON AVE, SUITE 100
GREENWOOD, IN 46142
Johnson County (317) 881-8248
REHABILITATION OPTIONS OF INDIANA
Social Worker (Clinical)
360 S MADISON AVE, 205
GREENWOOD, IN 46142
Johnson County (317) 887-1213
DR. BRENDA P VIEGAS M.D.
Pediatrics
360 S MADISON AVE, # 210
GREENWOOD, IN 46142
Johnson County (317) 881-3232

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 Grand Old Docs Of The Southside's NPI number?

The NPI number for Grand Old Docs Of The Southside is 1790886844. It was assigned to this organization in the NPPES registry on September 25, 2006. The provider is doing business as Central Indiana Medical Group.

Where is Grand Old Docs Of The Southside located?

Grand Old Docs Of The Southside is located at 360 S Madison Ave #200, Greenwood, IN 46142. The listed phone number is (317) 865-9090.

What is Grand Old Docs Of The Southside's specialty?

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

When was this NPI record last updated?

The NPPES record for Grand Old Docs Of The Southside was last updated on June 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.