Individual provider Active NPI

Jessica Dudley, CNM

  • Advanced Practice Midwife
  • East Chicago, IN
National Provider Identifier
1477364230
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
09000489A Issued in IN
Practice address
100 W Chicago Ave Ste F
East Chicago, IN 46312-3261
Phone
(219) 392-7016
Fax
(219) 397-6904
NPI assigned
Jan 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209.029607 IL
Advanced Practice Midwife 367A00000X 09000489A IN Primary

Addresses

Primary practice location

100 W Chicago Ave Ste F
East Chicago, IN 46312-3261

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7086

Other practice location 1

1801 W Taylor St
Chicago, IL 60612
Phone (312) 996-4175

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212002801 IN Practitioner - Certified Nurse Midwife (CNM) 0446780985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
219 Health Network IncGroup PAC ID 0547521452, 70 clinicians

Practice addresses (Care Compare)

100 W Chicago Ave
Suite F
East Chicago, IN 46312-3261
Phone (219) 392-7016

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209.029607ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
219 Health Network, Inc. CurrentSince Mar 1, 2025 Accepting new patients
219 Health Network Inc CurrentSince Mar 1, 2025 Accepting new patients
219 Health Network Inc Past Accepting new patients
219 Health Network, Inc. Past Accepting new patients
The Baby Academy USA LLC Advanced Practice Midwife Past Accepting new patients

Locations

100 W Chicago Ave
Ste F
East Chicago, IN 46312
Phone (219) 392-7016

4320 Fir St
Unit 408
East Chicago, IN 46312
Phone (219) 392-2847

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

Organizations & group practices 5

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 1

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": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1477364230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7086",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CHICAGO AVE STE F",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123261",
            "telephone_number": "219-392-7016",
            "fax_number": "219-397-6904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60612",
            "country_code": "US",
            "telephone_number": "312-996-4175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "JESSICA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209.029607",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "09000489A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.