Patient Care Services Team
NPI 1962822106ActiveOrganization· Nurse Practitioner, Gerontology· Noblesville, IN
Nurse Practitioner, Gerontology in Noblesville, Indiana, registered in NPPES in April 2014. The authorized official on file is Daniel Hollis, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962822106 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 25, 2014 |
| Last updated in NPPES | Aug 30, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Gerontology Primary | 363LG0600X | — | — |
| Family Medicine, Geriatric Medicine | 207QG0300X | — | — |
| Podiatrist, Primary Podiatric Medicine | 213EP1101X | — | — |
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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