Individual provider Active NPI

Jenni Thomas, NP

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1568531762
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71002134A Issued in IN
Practice address
8402 Harcourt Rd Ste 400
Indianapolis, IN 46260-2053
Phone
(317) 338-6815
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 71002134A IN Primary

Addresses

Primary practice location

8402 Harcourt Rd Ste 400
Indianapolis, IN 46260-2053

Mailing address

8402 Harcourt Rd Ste 400
Indianapolis, IN 46260-2053

Other practice location 1

8402 Harcourt Rd
Indianapolis, IN 46260-2074
Phone (317) 338-5288

Other identifiers 1

IdentifierTypeStateIssuer
200840920MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jenni.thomas.1@7598.direct.athenahealth.com St Vincent Pediatric Subspecialties

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71002134AINMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties Pediatrics Past Accepting new patients
Major Hospital Past Accepting new patients
St Vincent Pediatric Subspecialties Past Accepting new patients

Organizations & group practices 3

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1568531762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602053",
            "telephone_number": "317-338-6815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Harcourt Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602074",
            "country_code": "US",
            "telephone_number": "317-338-5288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JENNI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71002134A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200840920",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenni.thomas.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Vincent Pediatric Subspecialties",
            "address_1": "8402 Harcourt Rd Ste 400",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.