Individual provider Active NPI

Stephanie Sciaudone, FNP

  • Primary Care Nurse Practitioner
  • Anderson, IN
National Provider Identifier
1053771535
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
71006397A Issued in IN
Practice address
215 W 19TH St
Anderson, IN 46016-4204
Phone
(765) 393-3891
Fax
(765) 393-3892
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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 28140568A IN
Primary Care Nurse Practitioner 363LP2300X 71006397A IN Primary

Addresses

Primary practice location

215 W 19TH St
Anderson, IN 46016-4204

Mailing address

9615 E 148TH St
Suite 1
Noblesville, IN 46060-4360
Phone (317) 587-0500

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
I20160726001119 IN Practitioner - Nurse Practitioner 0547553729 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28140568AINMDFamily Nurse Practitioner
71006397AINMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Center of Indiana PC CurrentSince Mar 1, 2019 Accepting new patients
Aspire Indiana Health Inc. CurrentSince Jun 27, 2016 Accepting new patients

Locations

9615 E 148th St
Ste 1
Noblesville, IN 46060
Phone (317) 587-0500

1100 Southfield Dr
Ste 1240
Plainfield, IN 46168
Phone (317) 837-6082

6639 Whitestown Pkwy
Zionsville, IN 46077
Phone (317) 732-8980

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1053771535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 E 148TH ST",
            "address_2": "SUITE 1",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604360",
            "telephone_number": "317-587-0500",
            "fax_number": "317-674-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W 19TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164204",
            "telephone_number": "765-393-3891",
            "fax_number": "765-393-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIAUDONE",
        "first_name": "STEPHANIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28140568A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71006397A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.