Active NPI
Avery Batic, PA
- Physician Assistant
- Greenwood, IN
National Provider Identifier
1386588051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10005243A
- Practice address
- 555 E County Line Rd Ste 102
Greenwood, IN 46143-1064 - Phone
- (317) 706-7246
- Fax
- (317) 706-3417
- NPI assigned
- Apr 15, 2026
- Last updated
- Oct 7, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10005243A | IN | Primary |
Addresses
Primary practice location
555 E County Line Rd Ste 102
Greenwood, IN 46143-1064
Mailing address
29943 Network PL
Chicago, IL 60673-1299
Phone (317) 706-3415
Other names 1
- Avery Wagoner
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3738 Landmark Dr
Suite a
Lafayette, IN 47905-6655
Phone 3177067246309
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10005243A | IN | MD | Physician Assistant |
Organizations & group practices 1
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.
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- NPI 1477589000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791331200000",
"number": "1386588051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29943 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731299",
"telephone_number": "317-706-3415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 E COUNTY LINE RD STE 102",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461431064",
"telephone_number": "317-706-7246",
"fax_number": "317-706-3417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATIC",
"first_name": "AVERY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-15",
"last_updated": "2026-10-07",
"certification_date": "2026-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10005243A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AVERY",
"last_name": "WAGONER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.