Individual provider Active NPI

Jenna S. Reardon, AGPCNP-BC

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1477272805
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71014796A Issued in IN
Practice address
720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone
(317) 880-7666
Fax
(317) 880-0448
NPI assigned
Aug 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 71014796A IN Primary
Registered Nurse 163W00000X 28200120A IN

Addresses

Primary practice location

720 Eskenazi Ave
Indianapolis, IN 46202-5187

Mailing address

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

Other practice location 1

4772 Clifty Falls Ct
Indianapolis, IN 46239-9760
Phone (317) 201-9907

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jreardon9525@direct.eskenazihealth.edu

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
I20240318001474 IN Practitioner - Nurse Practitioner 3678910395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eskenazi Medical Group IncGroup PAC ID 4284546813, 134 clinicians

Practice addresses (Care Compare)

720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone (317) 880-7666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28200120AINMDRegistered Nurse
71014796AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eskenazi Medical Group Inc Nurse Practitioner CurrentSince Feb 12, 2024 Accepting new patients

Locations

720 Eskenazi Ave
Bldg 5TH
Indianapolis, IN 46202
Phone (317) 880-3818

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

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

Interoperability endpoints

  • Direct secure messaging: jreardon9525@direct.eskenazihealth.edu

Organizations & group practices 1

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.

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1477272805",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025187",
            "telephone_number": "317-880-7666",
            "fax_number": "317-880-0448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4772 Clifty Falls Ct",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462399760",
            "country_code": "US",
            "telephone_number": "317-201-9907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REARDON",
        "first_name": "JENNA",
        "middle_name": "S.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014796A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28200120A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jreardon9525@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "720 Eskenazi Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.