Individual provider Active NPI

Brooke Elise Nasser, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1295339208
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71010968A Issued in IN
Practice address
5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722
Phone
(317) 268-5741
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28229877A IN
Family Nurse Practitioner 363LF0000X 71010968A IN Primary

Addresses

Primary practice location

5926 Crawfordsville Rd Unit B
Indianapolis, IN 46224-3722

Mailing address

6784 Shooting Star Dr
Whitestown, IN 46075-6213
Phone (812) 236-2204

Other practice location 1

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 948-3967

Other names 1

  • Brooke Elise Humphrey Former name

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
I20210416001451 IN Practitioner - Nurse Practitioner 2860800513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Osh-in Physicians Group PCGroup PAC ID 6800100512, 62 clinicians

Practice addresses (Care Compare)

5926 Crawfordsville Rd
B
Speedway, IN 46224-3722
Phone (317) 653-2730

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28229877AINMDRegistered Nurse
71010968AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-in Physicians Group, PC Family CurrentSince May 10, 2021 Accepting new patients
Oak Street Health Physicians Group, PC Family PastSince Mar 21, 2021 Accepting new patients

Locations

5926 Crawfordsville Rd
Indianapolis, IN 46224
Phone (317) 653-2730

5926 Crawfordsville Rd
#B
Speedway, IN 46224
Phone (317) 653-2730

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1295339208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6784 SHOOTING STAR DR",
            "city": "WHITESTOWN",
            "state": "IN",
            "postal_code": "460756213",
            "telephone_number": "812-236-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5926 CRAWFORDSVILLE RD UNIT B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243722",
            "telephone_number": "317-268-5741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-948-3967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASSER",
        "first_name": "BROOKE",
        "middle_name": "ELISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28229877A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010968A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "HUMPHREY",
            "middle_name": "ELISE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.