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ST. MARY ADULT MEDICINE, LLC
NPI 1942481965
General Practice in Indianapolis, IN

Active since November 19, 2007CLIA 15D1053452 · Waiver
5525 GEORGETOWN RD STE F, INDIANAPOLIS, IN 46254(317) 293-9039(317) 293-9049 Get Directions Write a Review

NPPES record last updated: September 14, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About St. Mary Adult Medicine, Llc NPPES

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

ST. MARY ADULT MEDICINE, LLC (NPI 1942481965) is a healthcare organization registered as a general practice in Indianapolis, Indiana and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through October 27, 2027 and lists Malak G Hermina, Owner, as its authorized official.

NPPES Registry Identity

NPI1942481965
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameST. MARY ADULT MEDICINE, LLC
Location Address5525 GEORGETOWN RD STE FIndianapolis, IN 46254-3717
Mailing Address5525 Georgetown Rd, Suite FIndianapolis, IN 46254-3717 · (317) 293-9039 · Fax (317) 293-9049
Phone(317) 293-9039
Fax(317) 293-9049
Organization SubpartNo
Authorized OfficialMalak G HerminaOwner · (317) 293-9039
Enumeration DateNovember 19, 2007
Last NPPES UpdateSeptember 14, 2016
✔ NPI 1942481965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
5525 GEORGETOWN RD STE F, Indianapolis, IN 46254
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Other Identifiers 2

Medicaid201378550IN
Medicare UPIN56185IN

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 15D1053452

St Mary Adult Medicine · Indianapolis, IN
Active · expires Oct 27, 2027
CLIA Number15D1053452
Laboratory TypePhysician Office
Certificate Effective DateOctober 28, 2025
Certificate Expiration DateOctober 27, 2027
Laboratory DirectorMalak G. Hermina
Laboratory Phone(317) 293-9039
Laboratory LocationSt Mary Adult Medicine5525 Georgetown Rd Ste F, Indianapolis, IN 46254
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

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

DINA M MOURICE AGNP-C
Nurse Practitioner (Adult Health)
5525 GEORGETOWN RD STE F
INDIANAPOLIS, IN 46254
Marion County (317) 293-9039

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. Mary Adult Medicine, LLC's NPI number?

The NPI number for St. Mary Adult Medicine, LLC is 1942481965. It was assigned to this organization in the NPPES registry on November 19, 2007.

Where is St. Mary Adult Medicine, LLC located?

St. Mary Adult Medicine, LLC is located at 5525 Georgetown Rd Ste F, Indianapolis, IN 46254. The listed phone number is (317) 293-9039.

What is St. Mary Adult Medicine, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does St. Mary Adult Medicine, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D1053452) is associated with this NPI, valid through October 27, 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. Mary Adult Medicine, LLC was last updated on September 14, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.