Jeromy Michael Shoup, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71009462 Issued in IN

Practice address

1500 N Ritter Ave
Indianapolis, IN 46219-3027

Phone

(317) 355-1411

NPI assigned

Sep 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifespan Advanced Care LLCGroup PAC ID 7911484944, 15 clinicians

Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Hospitalist Medicine Physicians of Mississippi-TCS, Inc.Group PAC ID 1759824600, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital East Hospital, Indianapolis, IN, CCN 150074

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment Care Compare group NPD
• Lifespan Advanced Care LLC

  • Gerontology Nurse Practitioner
  • Carmel, IN
  • NPI 1558238345
  Medicare reassignment Care Compare group
• Hospitalist Medicine Physicians of Mississippi-TCS, Inc.

  • Internal Medicine Physician
  • St Augustine, FL
  • NPI 1023866597

  IN

  Medicare reassignment Care Compare group
• Proactive Clinical Partners

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
  • NPI 1366934242
  Medicare reassignment NPD
• Proactive Clinical Partners - Aco

  • Geriatric Medicine (Internal Medicine) Physician
  • Indianapolis, IN
  • NPI 1821709031
  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  dba Community Physician Network

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

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

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Care Compare affiliation

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789862400000",
    "number": "1053960120",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N RITTER AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193027",
            "telephone_number": "317-355-1411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "517 N Concord Rd",
            "address_purpose": "LOCATION",
            "city": "Crawfordsville",
            "state": "IN",
            "postal_code": "479339002",
            "country_code": "US",
            "telephone_number": "317-517-2339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOUP",
        "first_name": "JEROMY",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2026-09-20",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Short
• Timothy M Short, NP
• Amber Shots, COTA
• Corey Shotwell
• Charlotte Piket Shoulders, MSW
• Chastity Ann Shouse, OTR
• Craig Shouse, DPM
• Cory Dale Showalter, MD
• Carol Anne Showers, RNC-WHNP
• Kara Shrack, DC

• Family Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.