Individual provider Active NPI

Alex Qualkinbush, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1215664016
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71012855A Issued in IN
Practice address
7330 E 82ND St
Indianapolis, IN 46256-1465
Phone
(812) 200-2789
NPI assigned
Aug 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71012855A IN Primary

Addresses

Primary practice location

7330 E 82ND St
Indianapolis, IN 46256-1465

Mailing address

7330 E 82ND St
Indianapolis, IN 46256-1465
Phone (812) 200-2789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, VA2 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
I20220822001518 IN Practitioner - Nurse Practitioner 2668855867 Reassigns benefits to 3 organizations
I20251023001997 VA Practitioner - Nurse Practitioner 2668855867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Recover Together Inc 141 clinicians

Practice addresses (Care Compare)

100 Cherry Tree PLZ
Suite B
Washington, IN 47501-4539
Phone (800) 683-8313

1001 N Western Ave
Suite C
Marion, IN 46952-2568
Phone (800) 683-8313

1017 3Rd St
Columbus, IN 47201-6870
Phone (608) 977-7226

1359 E Margaret Dr
Groups Recover Together
Terre Haute, IN 47802-3213
Phone (800) 683-8313

1528 NW 5TH St
Suite 100
Richmond, IN 47374-1844
Phone (800) 683-8313

2508 Western Ave D
Recover Together Inc
Connersville, IN 47331-1800
Phone (800) 683-8313

3282 Mallard Cove LN
Fort Wayne, IN 46804-2883
Phone (800) 683-8313

614 Andrew Ave
La Porte, IN 46350-4677
Phone (800) 683-8313

6212 Jefferson Ave
Newport News, VA 23605-1500
Phone (800) 683-8313

905 W Keegans Way
Suite 9
Greensburg, IN 47240-3403
Phone (800) 683-8313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71012855AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Zalfi LLC Psychiatric/Mental Health CurrentSince Feb 10, 2023 Accepting new patients
Roadways to Recovery Inc., Psychiatric/Mental Health CurrentSince Aug 17, 2022 Accepting new patients

Locations

2620 Industrial Dr
Bedford, IN 47421
Phone (812) 583-6540

821 N State Road 135
Greenwood, IN 46142
Phone (317) 560-4300

1311 W 96th St
Ste 110
Indianapolis, IN 46260
Phone (317) 296-7707

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1215664016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 E 82ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561465",
            "telephone_number": "812-200-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 E 82ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561465",
            "telephone_number": "812-200-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALKINBUSH",
        "first_name": "ALEX",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71012855A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.