Provider Demographics
NPI:1609114578
Name:MEDEXPRESS URGENT CARE, P.C .- INDIANA
Entity type:Organization
Organization Name:MEDEXPRESS URGENT CARE, P.C .- INDIANA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-872-1472
Mailing Address - Street 1:2 OPTUM CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344
Mailing Address - Country:US
Mailing Address - Phone:317-872-1472
Mailing Address - Fax:317-802-7163
Practice Address - Street 1:8455 MOLLER RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268
Practice Address - Country:US
Practice Address - Phone:317-872-1472
Practice Address - Fax:317-802-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201134900 AMedicaid
IN201134900 AMedicaid
IN6766510001Medicare NSC