Individual provider Active NPI

Janet Sue Stockbridge, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1265540223
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71001349A Issued in IN
Practice address
1835 N Meridian St
Indianapolis, IN 46202-1411
Phone
(317) 957-2275
Fax
(317) 957-2280
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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 71001349A IN Primary

Addresses

Primary practice location

1835 N Meridian St
Indianapolis, IN 46202-1411

Mailing address

3403 E Raymond St
Health1St Wellness Centers
Indianapolis, IN 46203-4744
Phone (317) 957-2000

Other identifiers 1

IdentifierTypeStateIssuer
201268190MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001349AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthnet, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1265540223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 E RAYMOND ST",
            "address_2": "HEALTH1ST WELLNESS CENTERS",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462034744",
            "telephone_number": "317-957-2000",
            "fax_number": "317-957-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021411",
            "telephone_number": "317-957-2275",
            "fax_number": "317-957-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKBRIDGE",
        "first_name": "JANET",
        "middle_name": "SUE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001349A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201268190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.