Individual provider Active NPI

Jaclyn Demeter, PA-C

  • Physician Assistant
  • Carmel, IN
National Provider Identifier
1295184349
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002083A Issued in IN
Practice address
13225 N Meridian St
Carmel, IN 46032-5480
Phone
(317) 228-7000
Fax
(317) 228-2321
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002083A IN Primary

Addresses

Primary practice location

13225 N Meridian St
Carmel, IN 46032-5480

Mailing address

13225 N Meridian St
Carmel, IN 46032-5480
Phone (317) 228-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1295184349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13225 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325480",
            "telephone_number": "317-228-7000",
            "fax_number": "317-228-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13225 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325480",
            "telephone_number": "317-228-7000",
            "fax_number": "317-228-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETER",
        "first_name": "JACLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002083A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.