Individual provider Active NPI

Stephanie T Lennon, APRN

  • Primary Care Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1487713947
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
003468 Issued in CT
Practice address
2620 Kessler Boulevard East Dr Ste 110
Indianapolis, IN 46220-2889
Phone
(000) 000-0000
Fax
(203) 720-6996
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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 003468 CT
Primary Care Nurse Practitioner 363LP2300X 003468 CT Primary

Addresses

Primary practice location

2620 Kessler Boulevard East Dr Ste 110
Indianapolis, IN 46220-2889

Mailing address

126 Alpine Dr
Sandy Hook, CT 06482-1254
Phone (860) 933-6784

Other practice location 1

3030 Lake Ave Ste 21
Fort Wayne, IN 46805-5428
Phone (833) 904-2273

Other practice location 2

2301 N Meridian St
Indianapolis, IN 46208-5729
Phone (833) 904-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, IN, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20070117000114 CT Practitioner - Nurse Practitioner 9133120207 Reassigns benefits to 1 organization
I20231218000334 IN Practitioner - Nurse Practitioner 9133120207 Reassigns benefits to 1 organization
I20240813000496 FL Practitioner - Nurse Practitioner 9133120207 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3468CTMDClinical Psychologist
003468CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Windham Family Medical Services, PC CurrentSince Sep 4, 2012 Accepting new patients
Cityblock Medical Practice, P.a. CurrentSince Dec 1, 2023 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Jan 1, 2013 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

11 South Rd
Ste 130
Farmington, CT 06032
Phone (860) 224-5360

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

28 Professional Park Rd
Storrs, CT 06268
Phone (860) 487-9102

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

15416 N Florida Ave
Ste 203
Tampa, FL 33613
Phone (347) 463-5529

2620 Kessler Boulevard East Dr
Ste 110
Indianapolis, IN 46220
Phone (551) 804-3029

495 Flatbush Ave
Ste C5
Brooklyn, NY 11225
Phone (215) 588-1676

495 Flatbush Ave
Brooklyn, NY 11225
Phone 80033611001

Organizations & group practices 4

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1487713947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 ALPINE DR",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821254",
            "telephone_number": "860-933-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 KESSLER BOULEVARD EAST DR STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202889",
            "telephone_number": "000-000-0000",
            "fax_number": "203-720-6996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Lake Ave Ste 21",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468055428",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462085729",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENNON",
        "first_name": "STEPHANIE",
        "middle_name": "T",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003468",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "003468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.