Individual provider Active NPI

Rebbi C Coe, LPN

  • Licensed Practical Nurse
  • Indianapolis, IN
National Provider Identifier
1134735418
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
27072702A Issued in IN
Practice address
4069 Tahoe Dr
Indianapolis, IN 46235-8834
Phone
(317) 737-0008
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X
Personal Care Attendant 3747P1801X
Licensed Practical Nurse 164W00000X 27072702A IN Primary

Addresses

Primary practice location

4069 Tahoe Dr
Indianapolis, IN 46235-8834

Mailing address

11432 Mutz Cir
Indianapolis, IN 46229-2246
Phone (317) 737-0008

Other practice location 1

11432 Mutz Cir
Indianapolis, IN 46229-2246
Phone (317) 737-0008

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
27072702AINMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Good Stick Laboratory CurrentSince Jan 21, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1134735418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11432 MUTZ CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292246",
            "telephone_number": "317-737-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4069 TAHOE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462358834",
            "telephone_number": "317-737-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11432 Mutz Cir",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462292246",
            "country_code": "US",
            "telephone_number": "317-737-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COE",
        "first_name": "REBBI",
        "middle_name": "C",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27072702A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.