Individual provider Active NPI

Linda K Deardorff, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1235235573
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001520A Issued in IN
Practice address
7250 Clearvista Dr
Suite 380
Indianapolis, IN 46256-5608
Phone
(317) 621-7250
Fax
(317) 621-7255
NPI assigned
Sep 15, 2006
Last updated
May 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001520A IN Primary

Addresses

Primary practice location

7250 Clearvista Dr
Suite 380
Indianapolis, IN 46256-5608

Mailing address

7250 Clearvista Dr
Suite 380
Indianapolis, IN 46256-5608
Phone (317) 621-7250

Other identifiers 1

IdentifierTypeStateIssuer
200368640MedicaidIN

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001520AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1235235573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 CLEARVISTA DR",
            "address_2": "SUITE 380",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565608",
            "telephone_number": "317-621-7250",
            "fax_number": "317-621-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 CLEARVISTA DR",
            "address_2": "SUITE 380",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565608",
            "telephone_number": "317-621-7250",
            "fax_number": "317-621-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARDORFF",
        "first_name": "LINDA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001520A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200368640",
            "state": "IN"
        }
    ],
    "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 May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.