Individual provider Active NPI

Jennifer S Leblo, NP

  • Family Nurse Practitioner
  • Anderson, IN
National Provider Identifier
1245586916
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004028A Issued in IN
Practice address
1210 Medical Arts Blvd
Suite 201
Anderson, IN 46011-3461
Phone
(765) 298-5280
Fax
(765) 298-5279
NPI assigned
Jul 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004028A IN Primary

Addresses

Primary practice location

1210 Medical Arts Blvd
Suite 201
Anderson, IN 46011-3461

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 2

IdentifierTypeStateIssuer
P01157053OtherINRR MEDICARE PTAN
201082550MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jleblo31218@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
I20121017000743 IN Practitioner - Nurse Practitioner 4789834359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1601 Medical Arts Blvd
Suite 201
Anderson, IN 46011-3459
Phone (765) 298-4500

Hospital & facility affiliations

  • Community Hospital of Anderson and Madison County Hospital, Anderson, IN, CCN 150113
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074
  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 1, 2012 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 1, 2012 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1601 Medical Arts Blvd
Ste 201
Anderson, IN 46011
Phone (765) 298-4500

1210 Medical Arts Blvd
Ste 201
Anderson, IN 46011
Phone (765) 298-4044

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • Direct secure messaging: jleblo31218@ecommunitydirect.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1245586916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 MEDICAL ARTS BLVD",
            "address_2": "SUITE 201",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113461",
            "telephone_number": "765-298-5280",
            "fax_number": "765-298-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLO",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004028A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01157053",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201082550",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jleblo31218@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1210 Medical Arts Blvd",
            "address_2": "Suite 201",
            "city": "Anderson",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460113461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.