Individual provider Active NPI

Jennifer Elaine Radabaugh, N.P.

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1114019924
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71002264A Issued in IN
Practice address
8075 N Shadeland Ave
Suite 200
Indianapolis, IN 46250
Phone
(317) 621-8500
Fax
(317) 621-8501
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28149139A IN
Nurse Practitioner 363L00000X 71002264A IN Primary

Addresses

Primary practice location

8075 N Shadeland Ave
Suite 200
Indianapolis, IN 46250

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other practice location 1

707 W 2nd St
Bloomington, IN 47403-2209
Phone (812) 334-5081

Other identifiers 2

IdentifierTypeStateIssuer
P01210476OtherINRR MEDICARE PTAN
200924920MedicaidIN

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
I20071217000828 IN Practitioner - Nurse Practitioner 3870681968 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
Community Physician Network Specialty Care LLCGroup PAC ID 9931697265, 260 clinicians

Practice addresses (Care Compare)

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

8075 N Shadeland Ave
Indianapolis, IN 46250-2693

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28149139AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Ball Memorial Physicians, Inc. Nurse Practitioner CurrentSince Feb 19, 2014 Accepting new patients
Community Physician Network Specialty Care LLC CurrentSince Dec 24, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 1, 2013 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 1, 2013 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

3832 Solutions Ctr
Chicago, IL 60677

5918 Reliable Pkwy
Chicago, IL 60686

8075 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-8000

8075 N Shadeland Ave
Ste 200
Indianapolis, IN 46250
Phone (317) 621-8000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

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

1315 N Arlington Ave
Ste 100
Indianapolis, IN 46219
Phone (317) 322-2392

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

2525 W University Ave
Ste 502
Muncie, IN 47303
Phone (765) 286-5595

2525 W University Ave
Ste 300
Muncie, IN 47303
Phone (765) 289-5420

325 Westfield Rd
Ste A
Noblesville, IN 46060
Phone (317) 353-9336

Interoperability endpoints

  • Direct secure messaging: jekinsey@direct.iuhealth.org
  • Direct secure messaging: jkinsey6971@ecommunitydirect.com

Organizations & group practices 5

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 1

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1114019924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 N SHADELAND AVE",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46250",
            "telephone_number": "317-621-8500",
            "fax_number": "317-621-8501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032209",
            "country_code": "US",
            "telephone_number": "812-334-5081",
            "fax_number": "812-339-8344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADABAUGH",
        "first_name": "JENNIFER",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28149139A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002264A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01210476",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200924920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.