Jacqueline S. Nti, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01071071 Issued in IN

Practice address

7910 E Washington St Ste 210
Indianapolis, IN 46219-6803

Phone

(317) 355-5437

Fax

(317) 355-9047

NPI assigned

Jun 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jacqueline S. Berry Former name

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jnti224125@ecommunitydirect.com

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244

  Pediatrics

  Medicare reassignment NPD
• Eskenazi Medical Group Inc

  • Adult Medicine Physician
  • Indianapolis, IN
  • NPI 1730451063

  Pediatrics

  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Carmel Pediatrics, LLC

  • Pediatric Adolescent Medicine Physician
  • Carmel, IN
  • NPI 1457838450
  NPD (past)

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

{
    "created_epoch": "1244332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1033345822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-9312",
            "fax_number": "317-621-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 E WASHINGTON ST STE 210",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196803",
            "telephone_number": "317-355-5437",
            "fax_number": "317-355-9047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402121033",
            "country_code": "US",
            "telephone_number": "502-774-8631",
            "fax_number": "502-772-8189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NTI",
        "first_name": "JACQUELINE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-07",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "47602",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01071071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201069230",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnti224125@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7910 E Washington St Ste 210",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462196803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "BERRY",
            "middle_name": "S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aganze Nshombo Sr.
• Nspire Health Services LLC
• NST LLC
• NT Radiology Group, LLC
• Benjamin K Nti, MD
• Nu U Weight Loss
• Pamela Nubong
• Mary Applegate Nuckols I, FNP-C
• Nuclear Cardiology Centers, Inc
• Nuclear Cardiology Centers, Inc

• Pediatrics Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.