Individual provider Active NPI

Kelli Jo Sgro

  • Psychiatric/Mental Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1457222697
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71017127A Issued in IN
Practice address
1660 N Illinois St
Indianapolis, IN 46202-0059
Phone
(317) 880-2900
NPI assigned
Sep 12, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71017127A IN Primary

Addresses

Primary practice location

1660 N Illinois St
Indianapolis, IN 46202-0059

Mailing address

PO Box 637764
Cincinnati, OH 45263-7764
Phone (317) 880-3939

Other practice location 1

720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone (317) 880-0000

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
I20251209003153 IN Practitioner - Nurse Practitioner 1850885724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1660 N Illinois St
Eskenazi Health Center
Indianapolis, IN 46202-0059
Phone (317) 880-2900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71017127AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Health and Hospital Corporation of Marion County Student in an Organized Health Care Education/Training Program CurrentSince Jan 19, 2026 Accepting new patients
The Health and Hospital Corporation of Marion County CurrentSince Jan 19, 2026 Accepting new patients

Locations

1660 N Illinois St
Indianapolis, IN 46202
Phone (317) 880-2900

2732 W Michigan St
Indianapolis, IN 46222
Phone (317) 554-4600

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

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.

Hospital & facility affiliations 2

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": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1457222697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637764",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637764",
            "telephone_number": "317-880-3939",
            "fax_number": "317-880-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 N ILLINOIS ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462020059",
            "telephone_number": "317-880-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025187",
            "country_code": "US",
            "telephone_number": "317-880-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SGRO",
        "first_name": "KELLI",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71017127A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.