Individual provider Active NPI

Sukyong Rhee, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1154749638
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71004930A Issued in IN
Practice address
1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone
(317) 355-2560
Fax
(317) 355-2418
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28165403A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71004930A IN
Nurse Practitioner 363L00000X 71004930A IN Primary

Addresses

Primary practice location

1500 N Ritter Ave
Indianapolis, IN 46219-3027

Mailing address

6626 E 75TH Street
Ste 500
Indianapolis, IN 46250-2890

Other identifiers 1

IdentifierTypeStateIssuer
201235560MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srhee122941@eCommunityDirect.com Community Health Network, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140801000177 IN Practitioner - Certified Clinical Nurse Specialist (CNS) 2365668092 Reassigns benefits to 1 organization
I20150323001367 IN Practitioner - Nurse Practitioner 2365668092 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28165403AINMDRegistered Nurse
71004930AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc Current Accepting new patients
Indiana Behavioral Innovations LLC CurrentSince Mar 7, 2022 Accepting new patients
Community Howard Regional Health Inc CurrentSince Apr 19, 2015 Accepting new patients
Community Health Network, Inc CurrentSince Jun 6, 2014 Accepting new patients
Community Health Network, Inc. Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

205 N Jackson St
Frankfort, IN 46041
Phone (765) 659-4771

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

322 N Main St
Kokomo, IN 46901
Phone (765) 453-8238

1051 Southfield Dr
Plainfield, IN 46168
Phone (844) 991-9900

Interoperability endpoints

  • Direct secure messaging: srhee122941@ecommunitydirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1154749638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH STREET",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N RITTER AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193027",
            "telephone_number": "317-355-2560",
            "fax_number": "317-355-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEE",
        "first_name": "SUKYONG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28165403A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71004930A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004930A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201235560",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srhee122941@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Network, Inc",
            "address_1": "6950 Hillsdale Ct",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.