Active NPI
Laura J Kinnick, RN
- Nurse Practitioner
- Indianapolis, IN
National Provider Identifier
1316293541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71004069A
- Practice address
- 355 W 16TH St
Suite 5100
Indianapolis, IN 46202 - Phone
- (317) 396-1300
- Fax
- (317) 924-8472
- NPI assigned
- Jul 25, 2012
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71004069A | IN | Primary |
| Registered Nurse | 163W00000X | 28174769A | IN |
Addresses
Primary practice location
355 W 16TH St
Suite 5100
Indianapolis, IN 46202
Mailing address
PO Box 1329
Bloomington, IN 47402-1329
Other practice location 1
355 W 16th St
Suite 5100
Indianapolis, IN 46202-2207
Phone (317) 396-1300
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28174769A | IN | MD | Registered Nurse |
| 71004069A | IN | MD | Nurse Practitioner |
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.
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1316293541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1329",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474021329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 W 16TH ST",
"address_2": "SUITE 5100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46202",
"telephone_number": "317-396-1300",
"fax_number": "317-924-8472"
}
],
"practiceLocations": [
{
"address_1": "355 W 16th St",
"address_2": "Suite 5100",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462022207",
"country_code": "US",
"telephone_number": "317-396-1300",
"fax_number": "317-924-8472",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KINNICK",
"first_name": "LAURA",
"middle_name": "J",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-25",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71004069A",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28174769A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.