Individual provider Active NPI

Julie Hornbach Funk, PA

  • Medical Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1487913612
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10001379A Issued in IN
Practice address
8111 Township Line Rd
Indianapolis, IN 46260
Phone
(317) 415-7924
NPI assigned
May 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC642 KY
Medical Physician Assistant 363AM0700X TC642 KY
Medical Physician Assistant 363AM0700X 10001379A IN Primary

Addresses

Primary practice location

8111 Township Line Rd
Indianapolis, IN 46260

Mailing address

250 W 96TH St # 520
Indianapolis, IN 46260-1316

Other practice location 1

800 Rose St # MS -463
Lexington, KY 40536-1902
Phone (859) 323-0100

Other practice location 2

2001 W 86th St
Indianapolis, IN 46260-1902
Phone (317) 338-6728

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
I20120613000418 IN Practitioner - Physician Assistant 3476717968 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC642KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince May 13, 2012 Accepting new patients
St Vincent Pediatric Subspecialties CurrentSince Dec 3, 2018 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Physician Assistant CurrentSince May 13, 2012 Accepting new patients

Locations

8111 Township Line Rd
Indianapolis, IN 46260
Phone (317) 415-7921

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8081 Township Line Rd
Ste 203
Indianapolis, IN 46260
Phone (317) 415-7921

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

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": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1487913612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST # 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 TOWNSHIP LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-415-7924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St # MS -463",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405361902",
            "country_code": "US",
            "telephone_number": "859-323-0100",
            "fax_number": "859-257-6066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-338-6728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNK",
        "first_name": "JULIE",
        "middle_name": "HORNBACH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC642",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "TC642",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001379A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.