Provider Demographics
NPI:1528107851
Name:RIPPLE MEDICAL LLC
Entity type:Organization
Organization Name:RIPPLE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-927-2068
Mailing Address - Street 1:3266 N MERIDIAN ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5846
Mailing Address - Country:US
Mailing Address - Phone:317-927-2068
Mailing Address - Fax:317-927-2891
Practice Address - Street 1:3266 N MERIDIAN ST
Practice Address - Street 2:SUITE 801
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5846
Practice Address - Country:US
Practice Address - Phone:317-927-2068
Practice Address - Fax:317-927-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN04042411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN247670AOtherMEDICARE NUMBER
IN247670OtherGROUP MEDICARE
IND29093Medicare UPIN