Individual provider Active NPI

Andrea Kay Valentine, DNP, CPNP, NP-C, RN

  • Family Nurse Practitioner
  • Columbus, IN
National Provider Identifier
1568094688
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009749A Issued in IN
Practice address
2400 17TH St
Columbus, IN 47201-5351
Phone
(812) 376-5974
Fax
(812) 375-3203
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71009749A IN Primary

Addresses

Primary practice location

2400 17TH St
Columbus, IN 47201-5351

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avalentine21311@edirect.crh.org Direct

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
I20200312001039 IN Practitioner - Nurse Practitioner 9335577097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
71009749AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC CurrentSince Feb 18, 2020 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Feb 18, 2020 Accepting new patients

Locations

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

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.

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1568094688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 17TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015351",
            "telephone_number": "812-376-5974",
            "fax_number": "812-375-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINE",
        "first_name": "ANDREA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "DNP, CPNP, NP-C, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009749A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avalentine21311@edirect.crh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2400 17th St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.