Individual provider Active NPI

Kathleen McCracken, NP

  • Nurse Practitioner
  • Kokomo, IN
National Provider Identifier
1235341363
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71000337 Issued in IN
Practice address
3611 S Reed Rd
Kokomo, IN 46902-3806
Phone
(800) 777-7775
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 71000337 IN Primary

Addresses

Primary practice location

3611 S Reed Rd
Kokomo, IN 46902-3806

Mailing address

10845 Griffith Peak Dr # 2
Las Vegas, NV 89135-1553

Other identifiers 1

IdentifierTypeStateIssuer
200181320MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjohnson7514@eCommunityDirect.com Community Physicians of Indiana Inc

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140114001002 IN Practitioner - Nurse Practitioner 7810125150 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000337INMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jane Pauley Community Health Center Inc CurrentSince Jan 14, 2025 Accepting new patients

Locations

1503 N Mitthoefer Rd
Indianapolis, IN 46229

8931 E 30th St
Indianapolis, IN 46219
Phone (317) 355-9320

3510 S Lafountain St
Kokomo, IN 46902
Phone (765) 864-5760

3611 S Reed Rd
Kokomo, IN 46902
Phone (765) 400-2915

3611 S Reed Rd
Ste 108
Kokomo, IN 46902
Phone (765) 776-3700

Interoperability endpoints

  • Direct secure messaging: kjohnson7514@ecommunitydirect.com
  • Direct secure messaging: kmccracken746497@direct.ochin.org

Organizations & group practices 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1235341363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 GRIFFITH PEAK DR # 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S REED RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023806",
            "telephone_number": "800-777-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200181320",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjohnson7514@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "3506 S LaFountain St",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469023803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.