Individual provider Active NPI

Taylor Tunny, FNP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1033881776
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011766A Issued in IN
Practice address
3815 River Crossing Pkwy
Indianapolis, IN 46240-7746
Phone
(615) 454-9850
NPI assigned
Sep 30, 2021
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011766A IN Primary
Registered Nurse 163W00000X 28223882A IN

Addresses

Primary practice location

3815 River Crossing Pkwy
Indianapolis, IN 46240-7746

Mailing address

3815 River Crossing Pkwy Ste 100
Indianapolis, IN 46240-7766
Phone (844) 735-3314

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
I20211105001446 IN Practitioner - Nurse Practitioner 8426447871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Mobile MD Indiana LLCGroup PAC ID 9830607605, 29 clinicians

Practice addresses (Care Compare)

429 E Vermont St
Suite 110
Indianapolis, IN 46202-3685
Phone (317) 559-0950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28223882AINMDRegistered Nurse

Organizations & group practices 2

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": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1033881776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 RIVER CROSSING PKWY STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462407766",
            "telephone_number": "844-735-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 RIVER CROSSING PKWY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462407746",
            "telephone_number": "615-454-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNNY",
        "first_name": "TAYLOR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-11-22",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011766A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28223882A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.