Active NPI
Kathleen McCracken, NP
- Nurse Practitioner
- Kokomo, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71000337
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200181320 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000337 | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jane Pauley Community Health Center Inc | Current | 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
- kjohnson7514@ecommunitydirect.com
- 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.
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1730488818
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.