Indystathealthedu, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INDYSTATHEALTHEDU, LLC

Doing business as

IndyStatHealth
IndyStatHealth Care Group

Practice address

9465 Counselors Row Ste 200
Indianapolis, IN 46240-3817

Phone

(317) 260-9333

NPI assigned

Aug 20, 2020

Last updated

Apr 26, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

INDYSTATHEALTHEDU, LLCAs reported in NPPES

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

Authorized official

Name

Jerusha Keturah Seung, APRN, FNP-C, WCCNPI 1982863015

Title

Medical Director and Director of Ed

Phone

(317) 260-9333

Specialties & licenses 3

Addresses

Other names 2

• IndyStatHealth Doing business as
• IndyStatHealth Care Group Doing business as

Electronic endpoints 1

Part of

Indystathealthedu LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerusha K. Seung, MSN-ED, APRN, FNP-C,

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1982863015
  Authorized official Same address or phone

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1336751312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9465 COUNSELORS ROW STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462403817",
            "telephone_number": "317-260-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9465 COUNSELORS ROW STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462403817",
            "telephone_number": "317-260-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDYSTATHEALTHEDU, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDYSTATHEALTHEDU, LLC",
        "enumeration_date": "2020-08-20",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "SEUNG",
        "authorized_official_first_name": "JERUSHA",
        "authorized_official_middle_name": "KETURAH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR AND DIRECTOR OF ED",
        "authorized_official_telephone_number": "317-260-9333",
        "authorized_official_credential": "APRN, FNP-C, WCC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@indystathealthedu.com",
            "affiliation": "N",
            "endpointDescription": "info@indystathealthedu.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5699 E 71st St Ste 1A",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462203987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "IndyStatHealth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IndyStatHealth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IndyStatHealth Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.