Organization Active NPI

Lafayette Family Wellness, LLC

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1508590803
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LAFAYETTE FAMILY WELLNESS, LLC
Practice address
4050 Britt Farm Dr Ste C
Lafayette, IN 47905-0712
Phone
(937) 570-2448
NPI assigned
Jul 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Ryan Fay
Title
Ao
Phone
(937) 570-2448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4050 Britt Farm Dr Ste C
Lafayette, IN 47905-0712

Mailing address

179 W 550 S
Cutler, IN 46920-9307

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2268786Lafayette Family Wellness4050 Britt Farm Dr Suite C, Lafayette, IN 47905Certificate of waiverSep 15, 2026

National Provider Directory

National Provider Directory

Locations

4050 Britt Farm Dr
Ste C
Lafayette, IN 47905
Phone (765) 297-0696

NPI Registry JSON

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1508590803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 W 550 S",
            "city": "CUTLER",
            "state": "IN",
            "postal_code": "469209307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 BRITT FARM DR STE C",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479050712",
            "telephone_number": "937-570-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE FAMILY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "FAY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "937-570-2448"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.