Individual provider Active NPI

Kyra Cooke, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1023619947
Registry record updated Dec 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014934A Issued in IN
Practice address
5570 Goodwin St
Indianapolis, IN 46234
Phone
(317) 456-2062
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2024

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 71014934A IN Primary

Addresses

Primary practice location

5570 Goodwin St
Indianapolis, IN 46234

Mailing address

5570 Goodwin St
Indianapolis, IN 46234-9304
Phone (317) 443-8172

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
I20240309000324 IN Practitioner - Nurse Practitioner 5597908806 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Clinical PartnersGroup PAC ID 6608302872, 2 clinicians
Rpinmd LLCGroup PAC ID 4183014616, 13 clinicians

Practice addresses (Care Compare)

3500 Depauw Blvd
Indianapolis, IN 46268-1170
Phone (317) 443-8172

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Altea Medical Indiana PC CurrentSince May 11, 2024 Accepting new patients
Epic Clinical Partners Family CurrentSince Oct 1, 2024 Accepting new patients
Rpinmd LLC CurrentSince Mar 30, 2024 Accepting new patients
Post Acute Medical PLLC CurrentSince May 11, 2024 Accepting new patients
Epic Visionary Ventures LLC CurrentSince Oct 21, 2025 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

2350 Taft St
Gary, IN 46404
Phone (219) 944-2677

3114 E 46th St
Indianapolis, IN 46205
Phone (317) 920-7888

3500 Depauw Blvd
Indianapolis, IN 46268
Phone (317) 443-8172

3500 Depauw Blvd
Ste 10801
Indianapolis, IN 46268
Phone (317) 531-1783

3518 S Lafountain St
#3803
Kokomo, IN 46902
Phone (765) 453-4667

1101 E Coolspring Ave
Michigan City, IN 46360
Phone (219) 874-5211

295 Westfield Rd
Noblesville, IN 46060
Phone (317) 773-3760

Organizations & group practices 5

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1023619947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5570 GOODWIN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462349304",
            "telephone_number": "317-443-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5570 GOODWIN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46234",
            "telephone_number": "317-456-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "KYRA",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014934A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.