Basic Information
| Provider Information | |||||||||
| NPI: | 1164634887 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAMES-STEVENSON | ||||||||
| FirstName: | TOYIA | ||||||||
| MiddleName: | NICOLE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 N. RITTER AVENUE | ||||||||
| Address2: | SUITE 370 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462193098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173551144 | ||||||||
| FaxNumber: | 3173551155 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 N. RITTER AVENUE | ||||||||
| Address2: | SUITE 370 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462193098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173551144 | ||||||||
| FaxNumber: | 3173551155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 01/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01066296A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 01066296A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 200932780 | 05 | IN | MEDICAID |