Jaci R Glass, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71003660A Issued in IN

Practice address

6890 Collisi PL
Brownsburg, IN 46112-9134

Phone

(317) 835-1370

NPI assigned

Sep 13, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jaci R Faust Former name

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Indiana University Health Care Associates, Inc

  dba IU Health Physicians

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• University Family Physicians, Inc.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1043275787
  Medicare reassignment NPD
• University Family Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1669828042
  NPD
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

• Indiana University Health Bloomington Inc

  dba Iu Health Bloomington

  • General Acute Care Hospital
  • Bloomington, IN
  • NPI 1205860335
  Care Compare affiliation
• Indiana University Health Inc

  dba Indiana University Health

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1326320656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6890 COLLISI PL",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461129134",
            "telephone_number": "317-835-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6890 COLLISI PL",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461129134",
            "telephone_number": "317-835-1370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1199 Hadley Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "IN",
            "postal_code": "461581788",
            "country_code": "US",
            "telephone_number": "317-834-3263",
            "fax_number": "317-834-5194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-8776",
            "fax_number": "317-963-5285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASS",
        "first_name": "JACI",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71003660A",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "28174021A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201035270",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jglass529013@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1201 Hadley Rd",
            "city": "Mooresville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461581737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jglass@direct.iuhealth.orgg",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACI",
            "last_name": "FAUST",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ella Giedd, RBT
• Ella Gilbert, RBT
• Claire Gillen
• Lauren Gilmer, LSW
• Brianne Gittus
• Charmonic Glenn
• Samone Dorothea Glenn, FNP
• Veronica Goduto, RBT
• Carissa Goff, LCACA
• Tyreale Golden

• Adult Health Nurse Practitioner in Brownsburg, IN
• Providers in Brownsburg, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.