Old Town Medical Clinic
NPI 1548111503ActiveOrganization· General Practice· Noblesville, IN
General Practice in Noblesville, Indiana, registered in NPPES in February 2026. The authorized official on file is Cassidy Jayne McKinley, AGACNP-BC, Owner/Provider/Medical Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1548111503 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 5, 2026 |
| Last updated in NPPES | Feb 5, 2026 |
| Certified by provider | Feb 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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