CLEANSLATE MEDICAL GROUP OF INDIANA LLC
CLEANSLATE MEDICAL GROUP OF INDIANA LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1023464294, based in Alexandria, IN. The organization lists 2 taxonomy classifications, with Addiction Medicine (Internal Medicine) Physician recorded as primary.
Getting there
The practice address on file is 101 N HARRISON ST, Alexandria, IN 46001. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 4880963909
- Enrollment ID
- O20171023001515
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Addiction Medicine covers
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. NUCC Health Care Provider Taxonomy, code 207RA0401X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician Addiction Medicine | — | — | primary |
| 207R00000X | Internal Medicine Physician | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1023464294 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | May 6, 2016 |
| Last updated | Dec 17, 2025 |
| Status | Active |
| Practice address |
101 N HARRISON ST Alexandria, IN 46001 (765) 233-0903 Fax (833) 279-7074 |
| Mailing address |
8 CADILLAC DR STE 300 Brentwood, TN 37027 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 2 | 3 | 4 | 6 | 4 | 2 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 4 | 3 | 8 | 6 | 8 | 2 | 9 |
Sum = 66 · next multiple of 10 = 70 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.