NPIMap

Individual provider Active NPI

Breanna Kay Hostetler, FNP-C

  • Family Nurse Practitioner
  • Greentown, IN
National Provider Identifier
1093386617
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011377A Issued in IN
Practice address
118 S Meridian St
Greentown, IN 46936-1401
Phone
(765) 776-3030
Fax
(765) 453-8040
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 RN28229027A IN
Family Nurse Practitioner 363LF0000X 71011377A IN Primary

Addresses

Primary practice location

118 S Meridian St
Greentown, IN 46936-1401

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

3505 S Reed Rd
Kokomo, IN 46902-3838
Phone (765) 453-8666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803002048 IN Practitioner - Nurse Practitioner 4981008612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

118 S Meridian St
Greentown, IN 46936-1401
Phone (765) 628-7041

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN28229027AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Feb 20, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Feb 20, 2023 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

118 S Meridian St
Greentown, IN 46936
Phone (765) 453-8090

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

3505 S Reed Rd
Kokomo, IN 46902
Phone (765) 453-8666

Interoperability endpoints

  • Direct secure messaging: bhostetler548224@ecommunitydirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1093386617",
    "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": "118 S MERIDIAN ST",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469361401",
            "telephone_number": "765-776-3030",
            "fax_number": "765-453-8040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 S Reed Rd",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469023838",
            "country_code": "US",
            "telephone_number": "765-453-8666",
            "fax_number": "765-453-8506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "BREANNA",
        "middle_name": "KAY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "RN28229027A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011377A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greentown, IN

Sources for this page

Verify at the official NPI Registry.