Individual provider Active NPI

Jamie R Bohnke, NP

  • Pediatric Nurse Practitioner
  • Bedford, IN
National Provider Identifier
1023457637
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71004476A Issued in IN
Practice address
1614 25TH St
Bedford, IN 47421-5000
Phone
(812) 277-0118
Fax
(812) 277-0127
NPI assigned
Jun 17, 2013
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 71004476A IN Primary

Addresses

Primary practice location

1614 25TH St
Bedford, IN 47421-5000

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
201167860MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JBOHNKE@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250421002086 IN Practitioner - Nurse Practitioner 5496270605 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71004476AINMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC CurrentSince Mar 11, 2025 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Mar 11, 2025 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

1614 25th St
Bedford, IN 47421
Phone (812) 277-0118

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Interoperability endpoints

  • Direct secure messaging: jbohnke@direct.iuhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1023457637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 25TH ST",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474215000",
            "telephone_number": "812-277-0118",
            "fax_number": "812-277-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHNKE",
        "first_name": "JAMIE",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71004476A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201167860",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JBOHNKE@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1614 25th St",
            "city": "Bedford",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474215000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bedford, IN

Sources for this page

Verify at the official NPI Registry.