Individual provider Active NPI

Lynn A Whittaker, ANP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1114085248
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001064A Issued in IN
Practice address
421 Chestnut St
Evansville, IN 47713-1227
Phone
(812) 426-9372
Fax
(812) 858-4545
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001064A IN Primary
Adult Health Nurse Practitioner 363LA2200X 71001064A IN

Addresses

Primary practice location

421 Chestnut St
Evansville, IN 47713-1227

Mailing address

PO Box 3868
Evansville, IN 47737-3868
Phone (812) 426-9372

Other identifiers 3

IdentifierTypeStateIssuer
000000343441OtherANTHEM
200338530MedicaidIN
78013505OtherKYKY MEDICAID

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
I20041110000368 IN Practitioner - Nurse Practitioner 0840253878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

120 SE 4TH St
Evansville, IN 47708-1607
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660-1001
Phone (812) 749-6187

421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001064AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc. Nurse Practitioner Current Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner CurrentSince Oct 1, 2008 Accepting new patients
Deaconess Clinic Inc Nurse Practitioner CurrentSince Oct 1, 2008 Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4133 Gateway Blvd
Ste 290
Newburgh, IN 47630
Phone (812) 842-2701

4233 Gateway Blvd
Newburgh, IN 47630
Phone (812) 474-7116

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1114085248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3868",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477373868",
            "telephone_number": "812-426-9372",
            "fax_number": "812-858-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 CHESTNUT ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131227",
            "telephone_number": "812-426-9372",
            "fax_number": "812-858-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "LYNN",
        "middle_name": "A",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001064A",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71001064A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000343441",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200338530",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "78013505",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.