Individual provider Active NPI

Jessica F Purcell, FNP-BC

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1417449240
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008155A Issued in IN
Practice address
2400 Sagamore Pkwy S
Lafayette, IN 47905-5116
Phone
(765) 772-4086
Fax
(833) 638-0112
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71008155A IN Primary
Registered Nurse 163W00000X 28207266A IN

Addresses

Primary practice location

2400 Sagamore Pkwy S
Lafayette, IN 47905-5116

Mailing address

2400 Sagamore Pkwy S
Lafayette, IN 47905-5116
Phone (765) 772-4086

Other practice location 1

964 Mezzanine Dr
Lafayette, IN 47905
Phone (765) 446-8078

Other practice location 2

964 Mezzanine Dr
Lafayette, IN 47905
Phone (765) 446-8078

Other practice location 3

101 Suzie Ln
Attica, IN 47918-2009
Phone (765) 761-6205

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
I20220519000447 IN Practitioner - Nurse Practitioner 8325425044 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28207266AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Advanced Practice Network, P.C. CurrentSince Mar 17, 2022 Accepting new patients
Proactive Mso, LLC CurrentSince Jul 21, 2024 Accepting new patients

Locations

4656 W Jefferson Blvd
Ste 285
Fort Wayne, IN 46804
Phone (260) 422-9372

2400 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 772-4086

Interoperability endpoints

  • Direct secure messaging: jessica.purcell.1@14191.direct.athenahealth.com
  • Direct secure messaging: jessica.purcell@377412657217540.direct.elationemr.com
  • Direct secure messaging: jessica.purcell.1@23284.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1417449240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 SAGAMORE PKWY S",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055116",
            "telephone_number": "765-772-4086",
            "fax_number": "833-638-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SAGAMORE PKWY S",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055116",
            "telephone_number": "765-772-4086",
            "fax_number": "833-638-0112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "964 Mezzanine Dr",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "47905",
            "country_code": "US",
            "telephone_number": "765-446-8078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "964 Mezzanine Dr",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "47905",
            "country_code": "US",
            "telephone_number": "765-446-8078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Suzie Ln",
            "address_purpose": "LOCATION",
            "city": "Attica",
            "state": "IN",
            "postal_code": "479182009",
            "country_code": "US",
            "telephone_number": "765-761-6205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "JESSICA",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2024-07-09",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008155A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28207266A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.