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Organization

LITTLE CLINIC OF IN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS SHELLY (VP & GENERAL MANAGER)
(615) 425-4200
Entity
Organization

Contact information

Practice address
815 HIGHLANDER POINT DR, FLOYDS KNOBS, IN 47119-9470
(812) 923-7146
(812) 923-7157
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-0028
(615) 425-4200
(615) 425-4201

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201312240A
IN
05
201312240B
IN
05
201312240C
IN
05
201312240D
IN
05
201312240E
IN
05
201312240F
IN
05
201312240I
IN
05
201312240J
IN
05
201312240K
IN
05
201312240L
IN
05
201312240M
IN
05
201312240N
IN
05
201312240O
IN
05
201312240P
IN
05
201312240Q
IN
05
300000983
IN
05
300015621
IN
Enumeration date
11/14/2013
Last updated
10/21/2025
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