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Indian Wells Medical Center

Family Medicine Physician in Indian Wells, CA · enumerated 2006 · authorized official Corvin Kelly, Director/Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1548288574

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Registry record

Entity type Organization (Type 2)
Legal business name Indian Wells Medical Center
Other name <Unavail>
Practice address 74976 Us Highway 111, Indian Wells, CA, 92210
Phone (760) 568-4544
Fax (760) 568-4555
Enumeration date Jul 17, 2006
Last updated in NPPES Mar 15, 2008

Taxonomy & classification

111N00000X Chiropractor Chiropractic Providers · License DC26074 (CA) Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License A83821 (CA) Primary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians · License C29564 (CA) Secondary
208D00000X General Practice Physician Allopathic & Osteopathic Physicians · License A28654 (CA) Secondary
225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License PT19355 (CA) Secondary

Authorized official

Name Corvin Kelly
Title Director/Officer
Phone (760) 568-4544

Other identifiers

Identifier Type State Issuer
ZZZ13979Z Other CA BLUE SHIELD PROVIDER #
ZZZ13978Z Other CA BLUE SHIELD TRI-CARE WEST

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Indian Wells Medical Center?
Indian Wells Medical Center is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-03-15.