Individual provider Active NPI

Jaimie Kolanowski, PA-C

  • Physician Assistant
  • Lafayette, IN
National Provider Identifier
1073420626
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3750 Landmark Dr Ste a
Lafayette, IN 47905-6652
Phone
(765) 807-2780
Fax
(317) 706-3417
NPI assigned
Aug 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IN Primary

Addresses

Primary practice location

3750 Landmark Dr Ste a
Lafayette, IN 47905-6652

Mailing address

29943 Network PL
Chicago, IL 60673-1299
Phone (765) 807-2780

Other practice location 1

7950 Ortho Ln
Brownsburg, IN 46112-9354
Phone (317) 706-7146

Other practice location 2

2302 S Dixon Rd
Kokomo, IN 46902-6424
Phone (317) 706-7146

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1073420626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29943 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731299",
            "telephone_number": "765-807-2780",
            "fax_number": "317-706-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 LANDMARK DR STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479056652",
            "telephone_number": "765-807-2780",
            "fax_number": "317-706-3417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7950 Ortho Ln",
            "address_purpose": "LOCATION",
            "city": "Brownsburg",
            "state": "IN",
            "postal_code": "461129354",
            "country_code": "US",
            "telephone_number": "317-706-7146",
            "fax_number": "317-706-3417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2302 S Dixon Rd",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469026424",
            "country_code": "US",
            "telephone_number": "317-706-7146",
            "fax_number": "317-706-3417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLANOWSKI",
        "first_name": "JAIMIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.