Active NPI
Kelly Maureen Jaske, CPNP
- Nurse Practitioner
- Indianapolis, IN
National Provider Identifier
1184933459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71003371A
- Practice address
- 705 Riley Hospital Drive
Indianapolis, IN 46037 - Phone
- (317) 944-4093
- Fax
- (317) 944-3939
- NPI assigned
- Oct 4, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 71003371A | IN | |
| Nurse Practitioner | 363L00000X | 71003371A | IN | Primary |
Addresses
Primary practice location
705 Riley Hospital Drive
Indianapolis, IN 46037
Mailing address
705 Riley Hospital Drive
RM 1960
Indianapolis, IN 46037
Phone (317) 944-4093
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
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71003371A | IN | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1184933459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 RILEY HOSPITAL DRIVE",
"address_2": "RM 1960",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46037",
"telephone_number": "317-944-4093",
"fax_number": "317-944-3939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 RILEY HOSPITAL DRIVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46037",
"telephone_number": "317-944-4093",
"fax_number": "317-944-3939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASKE",
"first_name": "KELLY",
"middle_name": "MAUREEN",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-04",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IN",
"license": "71003371A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71003371A",
"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 Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.