Individual provider Active NPI

Alicia Kay Bates, NP

  • Nurse Practitioner
  • Decatur, IN
National Provider Identifier
1053391037
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001926A Issued in IN
Practice address
1100 Mercer Ave
Decatur, IN 46733-2303
Phone
(260) 724-2145
Fax
(260) 724-2145
NPI assigned
Jan 18, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001926A IN Primary

Addresses

Primary practice location

1100 Mercer Ave
Decatur, IN 46733-2303

Mailing address

955 High St
Ste 2
Decatur, IN 46733-2326
Phone (260) 724-8700

Other practice location 1

955 High St
Ste 2
Decatur, IN 46733-2326
Phone (260) 724-8700

Other identifiers 2

IdentifierTypeStateIssuer
200530800MedicaidIN
000000373877OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Adams County Memorial Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alicia.bates.1@14940.direct.athenahealth.com

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053391037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 HIGH ST",
            "address_2": "STE 2",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332326",
            "telephone_number": "260-724-8700",
            "fax_number": "260-728-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MERCER AVE",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332303",
            "telephone_number": "260-724-2145",
            "fax_number": "260-724-2145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 High St",
            "address_2": "Ste 2",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IN",
            "postal_code": "467332326",
            "country_code": "US",
            "telephone_number": "260-724-8700",
            "fax_number": "260-728-3821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATES",
        "first_name": "ALICIA",
        "middle_name": "KAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001926A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200530800",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000373877",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.