Individual provider Active NPI

Martha L Weinzapfel-Dick, ACNP

  • Acute Care Clinical Nurse Specialist
  • Evansville, IN
National Provider Identifier
1396988648
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
3008090 Issued in KY
Practice address
1312 Professional Blvd
Suite 200
Evansville, IN 47714-8007
Phone
(812) 491-6419
Fax
(812) 491-6465
NPI assigned
Apr 16, 2009
Last updated
Feb 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 3008090 KY
Acute Care Nurse Practitioner 363LA2100X 71002918A IN
Acute Care Clinical Nurse Specialist 364SA2100X 71002918A IN
Acute Care Clinical Nurse Specialist 364SA2100X 3008090 KY Primary

Addresses

Primary practice location

1312 Professional Blvd
Suite 200
Evansville, IN 47714-8007

Mailing address

1401 Professional Blvd Ste 101
Evansville, IN 47714-8011
Phone (812) 491-6419

Other identifiers 1

IdentifierTypeStateIssuer
200990730MedicaidIN

Other names 1

  • Martha L Dick Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20130803000030 KY Practitioner - Nurse Practitioner 0042362428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1312 Professional Blvd
Evansville, IN 47714-8007

1401 Professional Blvd
Suite 101
Evansville, IN 47714-8011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71002918AINMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Health, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: martha.weinzapfel.dick.1@7598.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1396988648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PROFESSIONAL BLVD STE 101",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148011",
            "telephone_number": "812-491-6419",
            "fax_number": "812-491-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 PROFESSIONAL BLVD",
            "address_2": "SUITE 200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148007",
            "telephone_number": "812-491-6419",
            "fax_number": "812-491-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINZAPFEL-DICK",
        "first_name": "MARTHA",
        "middle_name": "L",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3008090",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71002918A",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "IN",
            "license": "71002918A",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "KY",
            "license": "3008090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200990730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "DICK",
            "middle_name": "L",
            "credential": "ACNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.