Individual provider Active NPI

Rebecca J Davidhizar, AGACNP-C

  • Acute Care Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1245801604
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71011737A Issued in IN
Practice address
8333 Naab Rd Ste 250
Indianapolis, IN 46260-1983
Phone
(317) 338-5100
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 71011737A IN Primary

Addresses

Primary practice location

8333 Naab Rd Ste 250
Indianapolis, IN 46260-1983

Mailing address

8333 Naab Rd Ste 250
Indianapolis, IN 46260-1983
Phone (317) 338-5100

Other identifiers 1

IdentifierTypeStateIssuer
300056365MedicaidIN

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
I20211028001590 IN Practitioner - Nurse Practitioner 7214325943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Jun 23, 2024 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jun 23, 2024 Accepting new patients

Locations

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

8333 Naab Rd
Ste 250
Indianapolis, IN 46260
Phone (317) 338-5100

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1245801604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601983",
            "telephone_number": "317-338-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601983",
            "telephone_number": "317-338-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDHIZAR",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "AGACNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71011737A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300056365",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.