Individual provider Active NPI

Audra Marie St John, MD

  • Pediatric Gastroenterology Physician
  • Indianapolis, IN
National Provider Identifier
1144859950
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
01089400A Issued in IN
Practice address
575 Riley Hospital Dr
Indianapolis, IN 46202-5272
Phone
(317) 944-3774
Fax
(317) 944-8521
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 01089400A IN Primary

Addresses

Primary practice location

575 Riley Hospital Dr
Indianapolis, IN 46202-5272

Mailing address

PO Box 719094
Chicago, IL 60677-9318
Phone (317) 777-6435

Other identifiers 1

IdentifierTypeStateIssuer
300119188MedicaidIN

Other names 1

  • Audra Marie Rougraff Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619000753 IN Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9739501784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01089400AINMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group Riley Specialists, LLC Past 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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1144859950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779318",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025272",
            "telephone_number": "317-944-3774",
            "fax_number": "317-944-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JOHN",
        "first_name": "AUDRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IN",
            "license": "01089400A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300119188",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDRA",
            "last_name": "ROUGRAFF",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.