Kylie Henderson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71010612A Issued in IN

Practice address

12900 N Meridian St Ste 140
Carmel, IN 46032-5401

Phone

(765) 388-9491

NPI assigned

Dec 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleanslate Medical Group of Indiana LLCGroup PAC ID 4880963909, 60 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment Care Compare group NPD
• Recover Together, LLC

  • Adult Mental Health Clinic/Center
  • Lawrenceburg, IN
  • NPI 1891102497
  Medicare reassignment
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  NPD (past)

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

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1386240463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 N 500 E # N500E",
            "city": "WINDFALL",
            "state": "IN",
            "postal_code": "460769323",
            "telephone_number": "765-620-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 N MERIDIAN ST STE 140",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325401",
            "telephone_number": "765-388-9491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5062 N 500 E # N500E",
            "address_purpose": "LOCATION",
            "city": "Windfall",
            "state": "IN",
            "postal_code": "460769323",
            "country_code": "US",
            "telephone_number": "765-620-9432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KYLIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-05",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71010612A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010612A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aileen Helton, DDS
• Austin Martin Henderson, MD
• Dana Henderson
• Kailan Elizabeth Henderson
• Karin C Henderson, PA
• Roy Henderson, MD
• Hendricks County Hospital
• Lauren E Hendrickson, AUD
• Travis Hendrix
• Faith Henning, FNP-C

• Family Nurse Practitioner in Carmel, IN
• Providers in Carmel, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.