Jonathan Todd Agee, NP
Individual provider Active NPI Nurse Practitioner · Indianapolis, IN
NPI 1124243241 · NPPES record last updated Dec 21, 2015
Key facts
- NPI
- 1124243241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71000676A (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050506000588 | IN | Practitioner - Nurse Practitioner | 0143260364 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000676A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nora Urgent Care LLC | Current |
Accepting new patients | |
| Nora Urgent Care LLC | Current |
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
860 E 86th St
Ste 4
Indianapolis, IN 46240
Phone (317) 975-3441
650 N Girls School Rd
#F40
Indianapolis, IN 46214
Phone (317) 299-4033
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71000676A | IN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200489910 | Medicaid | IN |
Other providers in Indianapolis, IN
- Anuj K Agarwala
- Rachael K Agbonhese
- Ethel Flordelain Agbulos
- Katelyn Elizabeth Agdanowski
- Age Well Home Care Services LLC
- Stacy Agee
- Ageless Center LLC
- Ageless Love Home Care LLC
- Ageless Minds LLC
- Ageless Reflections Personal Care Services LLC
All providers in Indianapolis, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.