Caitlin Ackeret
Individual provider Active NPI Nurse Practitioner · Columbus, IN
NPI 1316655152 · NPPES record last updated Nov 10, 2022
Key facts
- NPI
- 1316655152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71013206A (IN)
- Practice address
- 2626 17TH St
Columbus, IN 47201-5417 - Phone
- (800) 841-4938
- Fax
- (812) 376-5610
- NPI assigned
- Nov 10, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240820002494 | IN | Order and Referring Only - Nurse Practitioner | 2769920800 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71013206A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/24308/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71013206A | IN | Yes |
Addresses
Primary practice location
2626 17TH St
Columbus, IN 47201-5417
Mailing address
2626 17TH St
Columbus, IN 47201-5417
Phone (812) 376-5609
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cackeret@crh.org |
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All providers in Columbus, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.