Individual provider Active NPI

Hannah Henderson, CPNP-PC

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1295218071
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
28209248A Issued in IN
Practice address
8402 Harcourt Rd Ste 320
Indianapolis, IN 46260-2052
Phone
(317) 338-2487
Fax
(317) 338-2867
NPI assigned
Sep 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 28209248A IN Primary

Addresses

Primary practice location

8402 Harcourt Rd Ste 320
Indianapolis, IN 46260-2052

Mailing address

8402 Harcourt Rd Ste 320
Indianapolis, IN 46260-2052
Phone (317) 338-2487

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hannah.henderson.1@7598.direct.athenahealth.com St Vincent Pediatric Subspecialties

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
I20180926002173 IN Practitioner - Nurse Practitioner 2264783588 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Jun 29, 2020 Accepting new patients
St Vincent Pediatric Subspecialties CurrentSince Jun 29, 2020 Accepting new patients
Major Hospital Past Accepting new patients
Riggs Community Health Center Inc Past Accepting new patients

Locations

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

8402 Harcourt Rd
Ste 320
Indianapolis, IN 46260
Phone (317) 338-2487

2316 South St
Lafayette, IN 47904
Phone (765) 447-6969

Organizations & group practices 4

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": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1295218071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 320",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602052",
            "telephone_number": "317-338-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 320",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602052",
            "telephone_number": "317-338-2487",
            "fax_number": "317-338-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "HANNAH",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "28209248A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hannah.henderson.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Vincent Pediatric Subspecialties",
            "address_1": "8402 Harcourt Rd Ste 320",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.