Individual provider Active NPI

Jenna Grile, NP

  • Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1407404866
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71009514A Issued in IN
Practice address
1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone
(812) 676-4300
Fax
(812) 339-8399
NPI assigned
Aug 29, 2019
Last updated
May 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71009514A IN Primary
Registered Nurse 163W00000X 28221722A IN

Addresses

Primary practice location

1520 S Liberty Dr
Bloomington, IN 47403-5167

Mailing address

1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone (812) 676-4300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JGRILE@direct.iuhealth.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311001589 IN Practitioner - Nurse Practitioner 6406281823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

583 S Clarizz Blvd
Iu Health Southern Indiana Physcia
Bloomington, IN 47401-5515
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28221722AINMDRegistered Nurse
71009514AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Nurse Practitioner CurrentSince Jan 25, 2020 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Jan 25, 2020 Accepting new patients
Iu Health Medical Group, LLC Nurse Practitioner CurrentSince Jan 3, 2026 Accepting new patients

Locations

2900 16th St
Bedford, IN 47421
Phone (812) 275-1200

1520 S Liberty Dr
Bloomington, IN 47403
Phone (812) 676-4300

583 S Clarizz Blvd
Bloomington, IN 47401
Phone (812) 333-2663

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: jgrile@direct.iuhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1407404866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035167",
            "telephone_number": "812-676-4300",
            "fax_number": "812-339-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035167",
            "telephone_number": "812-676-4300",
            "fax_number": "812-339-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILE",
        "first_name": "JENNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009514A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28221722A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JGRILE@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "583 S Clarizz Blvd",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474015515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.