Jeri Dine, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71000423A Issued in IN

Practice address

1600 Albany St
South Entrance Ground Floor
Beech Grove, IN 46107-1541

Phone

(317) 859-1090

Fax

(317) 859-3322

NPI assigned

Nov 28, 2007

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 9

Other names 1

• Jeri Galloway Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Advanced Healthcare Associates LLP

  • Geriatric Medicine (Internal Medicine) Physician
  • Elwood, IN
  • NPI 1841225091

  Nurse Practitioner

  NPD (past)
• T.L. Care, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Indianapolis, IN
  • NPI 1982772935
  NPD (past)

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366624728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461070100",
            "telephone_number": "317-859-1090",
            "fax_number": "317-859-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ALBANY ST",
            "address_2": "SOUTH ENTRANCE GROUND FLOOR",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461071541",
            "telephone_number": "317-859-1090",
            "fax_number": "317-859-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINE",
        "first_name": "JERI",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000423A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000423A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP CERTIFICATION",
            "identifier": "0011953-21",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M PLAN",
            "identifier": "000000041022",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "35-4994904",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00068634",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11478722",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "28065854A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "71000423B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000550394",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200307870",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERI",
            "last_name": "GALLOWAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Nicole Cole
• Kathleen Lynn Cowden, R.D.
• David J. Black, MD, LLC
• Chad Eric Deerberg
• Barbara Dempsey
• Georgia K Dorulla, MD
• Doug Taylor Prosthetics Inc
• Paul E Driscoll, MD
• Kailyn Loren Duane
• James Dycus, PHARMD

• Adult Health Nurse Practitioner in Beech Grove, IN
• Providers in Beech Grove, 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 Mar 7, 2023; 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.