Individual provider Active NPI

Elizabeth P Wadleigh, NURSE PRACTITIONER

  • Registered Nurse
  • Indianapolis, IN
National Provider Identifier
1467264408
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28226471 Issued in IN
Practice address
3830 W 96TH St
Indianapolis, IN 46268-2907
Phone
(317) 854-0604
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28226471 IN Primary

Addresses

Primary practice location

3830 W 96TH St
Indianapolis, IN 46268-2907

Mailing address

3830 W 96TH St
Indianapolis, IN 46268-2907
Phone (317) 854-0604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28226471INMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1467264408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 W 96TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462682907",
            "telephone_number": "317-854-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 W 96TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462682907",
            "telephone_number": "317-854-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLEIGH",
        "first_name": "ELIZABETH",
        "middle_name": "P",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28226471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.