Individual provider Active NPI

Benjamin Commons, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1023461084
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006416A Issued in IN
Practice address
8402 Harcourt Rd Ste 300
Indianapolis, IN 46260-2052
Phone
(317) 338-3100
NPI assigned
Jul 14, 2016
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006416A IN Primary

Addresses

Primary practice location

8402 Harcourt Rd Ste 300
Indianapolis, IN 46260-2052

Mailing address

8402 Harcourt Rd Ste 300
Indianapolis, IN 46260-2052

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address benjamin.commons.1@7598.direct.athenahealth.com St Vincent Pediatric Subspecialties

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
I20160902000519 IN Practitioner - Nurse Practitioner 6406142280 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties CurrentSince Aug 29, 2016 Accepting new patients
St Vincent Pediatric Subspecialties Family CurrentSince Aug 29, 2016 Accepting new patients
Major Hospital Past Accepting new patients

Locations

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8402 Harcourt Rd
Ste 300
Indianapolis, IN 46260
Phone (317) 338-3100

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1023461084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602052",
            "telephone_number": "317-338-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMMONS",
        "first_name": "BENJAMIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006416A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benjamin.commons.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Vincent Pediatric Subspecialties",
            "address_1": "8402 Harcourt Rd Ste 300",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.