Individual provider Active NPI

Neena Livermore, FNP-C

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1083013957
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71005066A Issued in IN
Practice address
415 Mulberry St
Evansville, IN 47713-1230
Phone
(812) 423-7791
Fax
(812) 422-7558
NPI assigned
Aug 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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 71005066A IN Primary

Addresses

Primary practice location

415 Mulberry St
Evansville, IN 47713-1230

Mailing address

415 Mulberry St
Evansville, IN 47713-1230
Phone (812) 423-7791

Other identifiers 3

IdentifierTypeStateIssuer
000000966316OtherINANTHEM
201248200MedicaidIN
834950008OtherINMEDICARE

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
I20140929002109 IN Practitioner - Nurse Practitioner 4385864164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Behavioral Healthcare IncGroup PAC ID 7315842309, 37 clinicians

Practice addresses (Care Compare)

415 Mulberry St
Evansville, IN 47713-1230
Phone (812) 423-7791

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71005066AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Oct 26, 2015 Accepting new patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Oct 26, 2015 Accepting new patients

Locations

414 SE 4th St
Ste 101
Evansville, IN 47713
Phone (812) 424-4880

415 Mulberry St
Evansville, IN 47713
Phone (812) 436-4232

320 S 5th Ave
Princeton, IN 47670
Phone (812) 385-5275

Organizations & group practices 2

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 3

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": "1408233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1083013957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-423-7791",
            "fax_number": "812-422-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-423-7791",
            "fax_number": "812-422-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVERMORE",
        "first_name": "NEENA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-17",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005066A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000966316",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201248200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "834950008",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.