Individual provider Active NPI

Hannah Jean Shideler

  • Family Nurse Practitioner
  • Crawfordsville, IN
National Provider Identifier
1497422638
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012943A Issued in IN
Practice address
1710 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone
(765) 361-3020
Fax
(765) 364-3282
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28230342A IN
Family Nurse Practitioner 363LF0000X 71012943A IN Primary

Addresses

Primary practice location

1710 Lafayette Rd
Crawfordsville, IN 47933-1033

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

3662 S 450 W
West Lebanon, IN 47991-8051
Phone (765) 585-8545

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
I20221110000534 IN Practitioner - Nurse Practitioner 5698142214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1710 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone (765) 364-8942

Hospital & facility affiliations

  • Franciscan Health Crawfordsville Hospital, Crawfordsville, IN, CCN 150022
  • Franciscan Health Lafayette Hospital, Lafayette, IN, CCN 150109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71012943AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Oct 9, 2022 Accepting new patients
Franciscan Physician Network CurrentSince Oct 9, 2022 Accepting new patients

Locations

1710 Lafayette Rd
Crawfordsvlle, IN 47933
Phone (765) 362-2800

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 2

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 3

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1497422638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 LAFAYETTE RD",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479331033",
            "telephone_number": "765-361-3020",
            "fax_number": "765-364-3282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3662 S 450 W",
            "address_purpose": "LOCATION",
            "city": "West Lebanon",
            "state": "IN",
            "postal_code": "479918051",
            "country_code": "US",
            "telephone_number": "765-585-8545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIDELER",
        "first_name": "HANNAH",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28230342A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012943A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordsville, IN

Sources for this page

Verify at the official NPI Registry.