Individual provider Active NPI

Joanna Marie Fay, FNP

  • Family Nurse Practitioner
  • Granger, IN
National Provider Identifier
1497234074
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008486A Issued in IN
Practice address
130 E Cleveland Rd
Granger, IN 46530-5620
Phone
(574) 247-2221
NPI assigned
Aug 14, 2018
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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 71008486A IN Primary
Family Nurse Practitioner 363LF0000X 71008486B IN

Addresses

Primary practice location

130 E Cleveland Rd
Granger, IN 46530-5620

Mailing address

130 E Cleveland Rd
Granger, IN 46530-5620
Phone (574) 247-2221

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
I20181108000535 IN Practitioner - Nurse Practitioner 4486908506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostics of Indiana LLCGroup PAC ID 3072548502, 121 clinicians

Practice addresses (Care Compare)

4501 Lincolnway E
Mishawaka, IN 46544-4035
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71008486AINMDFamily Nurse Practitioner
71008486BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostics of Indiana, LLC Family CurrentSince Oct 19, 2018 Accepting new patients

Locations

130 E Cleveland Rd
Granger, IN 46530
Phone (574) 247-2221

9805 Geist Crossing Dr
Indianapolis, IN 46256
Phone (317) 577-1353

4501 Lincolnway E
Mishawaka, IN 46544
Phone (574) 255-4729

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1497234074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E CLEVELAND RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465305620",
            "telephone_number": "574-247-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E CLEVELAND RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465305620",
            "telephone_number": "574-247-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAY",
        "first_name": "JOANNA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008486A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008486B",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.