Individual provider Active NPI

Jonathan Todd Agee, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1124243241
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71000676A Issued in IN
Practice address
8320 Madison Ave
Suite H
Indianapolis, IN 46227-6066
Phone
(317) 381-5252
Fax
(317) 859-5304
NPI assigned
Apr 16, 2007
Last updated
Dec 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71000676A IN Primary

Addresses

Primary practice location

8320 Madison Ave
Suite H
Indianapolis, IN 46227-6066

Mailing address

200E Fairman Ave
Watseka, IL 60970-1644
Phone (765) 969-3678

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
I20050506000588 IN Practitioner - Nurse Practitioner 0143260364 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000676AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nora Urgent Care LLC CurrentSince Sep 1, 2018 Accepting new patients
Nora Urgent Care LLC CurrentSince Sep 1, 2018 Accepting new patients
Major Hospital Past Accepting new patients
Amh, Inc Past Accepting new patients
Central Indiana OB/GYN, LLC Past Accepting new patients

Locations

650 N Girls School Rd
#F40
Indianapolis, IN 46214
Phone (317) 299-4033

860 E 86th St
Ste 4
Indianapolis, IN 46240
Phone (317) 975-3441

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1124243241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "765-969-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "address_2": "SUITE H",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-381-5252",
            "fax_number": "317-859-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGEE",
        "first_name": "JONATHAN",
        "middle_name": "TODD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000676A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.