Andrea Christine Stafford, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71006135A Issued in IN

Practice address

8040 Clearvista Pkwy
Ste 460
Indianapolis, IN 46256-5630

Phone

(317) 621-2660

Fax

(317) 621-1535

NPI assigned

Nov 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Andrea Christine Harlow Former name

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aharlow4805@ecommunitydirect.com
• Direct secure messaging: astafford3@direct.iuhealth.org

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777

  Nurse Practitioner

  Medicare reassignment NPD
• Pediatric Surgical Associates Inc

  • Pediatric Surgery Physician
  • Indianapolis, IN
  • NPI 1790880292
  Medicare reassignment
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1629258173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 CLEARVISTA PKWY",
            "address_2": "STE 460",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565630",
            "telephone_number": "317-621-2660",
            "fax_number": "317-621-1535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11700 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460324656",
            "country_code": "US",
            "telephone_number": "317-944-4681",
            "fax_number": "317-944-9740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "ANDREA",
        "middle_name": "CHRISTINE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006135A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN185930",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71006135A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01678745",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201350080",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aharlow4805@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8040 Clearvista Pkwy",
            "address_2": "Ste 460",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462565630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "astafford@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11700 N Meridian St",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460324656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "HARLOW",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nathan M Stadem
• Henry William Stadler V, MD
• Nathan Alan Stadnik, PHARMD
• Nicholas Staehler, MD
• Sandra S Staehler, NP
• Jeremy Stafford, RBT
• Jillian Marie Stafford
• Madeline Stafford, PA
• Natalie R Stafford, NP
• Tyler D Stafford

• Pediatric Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.