Individual provider Active NPI

Kendra Payton Nienaber, FNP-BC

  • Family Nurse Practitioner
  • Newburgh, IN
National Provider Identifier
1104777465
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71017667A Issued in IN
Practice address
5233 Rosebud LN
Newburgh, IN 47630-9283
Phone
(812) 473-4761
Fax
(812) 473-4761
NPI assigned
Feb 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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 71017667A IN Primary

Addresses

Primary practice location

5233 Rosebud LN
Newburgh, IN 47630-9283

Mailing address

5233 Rosebud LN
Newburgh, IN 47630-9283
Phone (812) 473-4761

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
71017667AINMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1104777465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5233 ROSEBUD LN",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309283",
            "telephone_number": "812-473-4761",
            "fax_number": "812-473-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 ROSEBUD LN",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309283",
            "telephone_number": "812-473-4761",
            "fax_number": "812-473-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIENABER",
        "first_name": "KENDRA",
        "middle_name": "PAYTON",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71017667A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.