EAGLE CREEK DERMATOLOGY
EAGLE CREEK DERMATOLOGY is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1053561928, based in Indianapolis, IN. The organization lists 2 taxonomy classifications, with Clinical & Laboratory Dermatological Immunology Physician recorded as primary.
Getting there
The practice address on file is 6820 PARKDALE PL SUITE 211, Indianapolis, IN 46254. 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
| Licence | State | Specialty |
|---|---|---|
| 01024873 | IN | Clinical & Laboratory Dermatological… primary |
| 01027554 | IN | Dermatology Physician |
| 01057248 | IN | Clinical & Laboratory Dermatological… |
This provider holds licence 01024873 issued in IN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 8921131731
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Clinical & Laboratory Dermatological Immunology covers
A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases. NUCC Health Care Provider Taxonomy, code 207NI0002X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician Clinical & Laboratory Dermatological Immunology | 01024873 | IN | primary |
| 207N00000X | Dermatology Physician | 01027554 | IN | |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician Clinical & Laboratory Dermatological Immunology | 01057248 | IN |
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 | 1053561928 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Sep 26, 2008 |
| Last updated | Sep 11, 2013 |
| Status | Active |
| Practice address |
6820 PARKDALE PL SUITE 211 Indianapolis, IN 46254 (317) 329-7050 Fax (317) 328-6809 |
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 | 5 | 3 | 5 | 6 | 1 | 9 | 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 1 | 3 | 1 | 6 | 2 | 9 | 4 |
Sum = 52 · next multiple of 10 = 60 · check digit = 8 · actual last digit = 8
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.