Individual provider Active NPI

Jani Sue Reisinger, FNP

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1063960540
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006536A Issued in IN
Practice address
25 W Division St
Evansville, IN 47710-1374
Phone
(812) 436-0205
Fax
(812) 602-2172
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006536A IN Primary

Addresses

Primary practice location

25 W Division St
Evansville, IN 47710-1374

Mailing address

315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489

Other identifiers 1

IdentifierTypeStateIssuer
201396510MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgardner89179@direct.deaconess.com Direct

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
I20161024001683 IN Practitioner - Nurse Practitioner 1153609326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Echo Community Health Care IncGroup PAC ID 4981515145, 18 clinicians

Practice addresses (Care Compare)

25 W Division St
Evansville, IN 47710-1374
Phone (812) 436-0205

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Echo Community Health Care, Inc. CurrentSince Sep 20, 2016 Accepting new patients
Echo Community Health Care, Inc. Current Accepting new patients
Echo Community Health Care, Inc CurrentSince Sep 20, 2016 Accepting new patients

Locations

401 John St
Evansville, IN 47713
Phone (812) 436-0224

315 Mulberry St
Evansville, IN 47713
Phone (812) 421-7489

25 W Division St
Evansville, IN 47710
Phone (812) 436-0205

Interoperability endpoints

  • Direct secure messaging: jreisinger171233@direct.deaconess.com
  • Direct secure messaging: sgardner89179@direct.deaconess.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1063960540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131252",
            "telephone_number": "812-421-7489",
            "fax_number": "812-436-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W DIVISION ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101374",
            "telephone_number": "812-436-0205",
            "fax_number": "812-602-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISINGER",
        "first_name": "JANI",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006536A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201396510",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgardner89179@direct.deaconess.com",
            "affiliation": "N",
            "endpointDescription": "ECHO Community Healthcare, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 W Division St",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477101374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.