Active NPI
Abigail Elizabeth McIntosh, FNP-C
- Nurse Practitioner
- Evansville, IN
National Provider Identifier
1245846963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71010596A
- Practice address
- 309 N First Ave
Evansville, IN 47710-1218 - Phone
- (812) 450-4066
- Fax
- (812) 450-3886
- NPI assigned
- Sep 17, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 28209562A | IN | |
| Nurse Practitioner | 363L00000X | 71010596A | IN | Primary |
Addresses
Primary practice location
309 N First Ave
Evansville, IN 47710-1218
Mailing address
PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-4066
Other practice location 1
4055 Valley View Ln Ste 400
Dallas, TX 75244-5071
Phone (972) 715-3800
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201202002716 | IN | Order and Referring Only - Nurse Practitioner | 5294146833 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28209562A | IN | MD | Medical-Surgical Registered Nurse |
| 71010596A | IN | MD | Nurse Practitioner |
Interoperability endpoints
- amcintosh207694@direct.deaconess.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1245846963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1510",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477061510",
"telephone_number": "812-450-4066",
"fax_number": "812-450-3886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 N FIRST AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477101218",
"telephone_number": "812-450-4066",
"fax_number": "812-450-3886"
}
],
"practiceLocations": [
{
"address_1": "4055 Valley View Ln Ste 400",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752445071",
"country_code": "US",
"telephone_number": "972-715-3800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCINTOSH",
"first_name": "ABIGAIL",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-17",
"last_updated": "2020-12-03",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "IN",
"license": "28209562A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71010596A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.