Individual provider Active NPI

Peggy Ann Dulhanty

  • Family Nurse Practitioner
  • Marion, IN
National Provider Identifier
1063453215
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71000613A Issued in IN
Practice address
1700 E 38TH St
Marion, IN 46953-4568
Phone
(765) 674-3321
Fax
(765) 677-5162
NPI assigned
Jun 9, 2006
Last updated
Aug 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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 71000613A IN Primary
Registered Nurse 163W00000X 28092871 IN

Addresses

Primary practice location

1700 E 38TH St
Marion, IN 46953-4568

Mailing address

2355 E Bocock Rd
Marion, IN 46952-8751
Phone (765) 664-7429

Other identifiers 1

IdentifierTypeStateIssuer
200196650AMedicaidIN

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

State licenses

LicenseStateTypeSpecialty
28092871INMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Carey Services, Inc. Family Past Accepting new patients

Organizations & group practices 1

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1063453215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 E BOCOCK RD",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469528751",
            "telephone_number": "765-664-7429",
            "fax_number": "765-668-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 38TH ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469534568",
            "telephone_number": "765-674-3321",
            "fax_number": "765-677-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULHANTY",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000613A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28092871",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200196650A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.