Individual provider Active NPI

Stephanie Elliott

  • Family Nurse Practitioner
  • Greencastle, IN
National Provider Identifier
1144767526
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007175A Issued in IN
Practice address
1542 S Bloomington St
Greencastle, IN 46135-2212
Phone
(765) 301-7400
NPI assigned
Jan 24, 2017
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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 71007175A IN
Family Nurse Practitioner 363LF0000X 71007175A IN Primary

Addresses

Primary practice location

1542 S Bloomington St
Greencastle, IN 46135-2212

Mailing address

1145 Indianapolis Rd
Greencastle, IN 46135-2408
Phone (657) 653-8453

Other identifiers 1

IdentifierTypeStateIssuer
300005209MedicaidIN

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
I20170807002260 IN Practitioner - Nurse Practitioner 3375814585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Putnam County HospitalGroup PAC ID 1951396605, 46 clinicians

Practice addresses (Care Compare)

1542 S Bloomington St
Putnam Prompt Care
Greencastle, IN 46135-2212
Phone (765) 655-2686

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Putnam County Hospital CurrentSince Jan 30, 2020 Accepting new patients
Putnam County Hospital Current Accepting new patients
Putnam County Hospital CurrentSince Jan 30, 2020 Accepting new patients
Putnam County Hospital Past Accepting new patients

Locations

1111 S Calbert Way
Greencastle, IN 46135
Phone (317) 781-1133

1542 S Bloomington St
Greencastle, IN 46135
Phone (765) 522-2556

1542 S Bloomington St
#1100
Greencastle, IN 46135
Phone (765) 658-2700

1542 S Bloomington St
Ste 1100
Greencastle, IN 46135
Phone (765) 658-2700

Interoperability endpoints

  • Direct secure messaging: selliott38093@direct.franciscanalliance.org

Organizations & group practices 4

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.

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": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1144767526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 INDIANAPOLIS RD",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352408",
            "telephone_number": "657-653-8453",
            "fax_number": "657-653-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 S BLOOMINGTON ST",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352212",
            "telephone_number": "765-301-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007175A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007175A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005209",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greencastle, IN

Sources for this page

Verify at the official NPI Registry.