Individual provider Active NPI

Janis Farquhar Stevenson, ACNP

  • Acute Care Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1649265869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71001894A Issued in IN
Practice address
2920 McIntyre Dr
Suite 150
Bloomington, IN 47403-4221
Phone
(812) 333-7246
Fax
(812) 333-4471
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 71001894A IN Primary

Addresses

Primary practice location

2920 McIntyre Dr
Suite 150
Bloomington, IN 47403-4221

Mailing address

PO Box 5635
Attn: Maria Mitchell
Bloomington, IN 47407-5635
Phone (812) 337-5003

Other identifiers 2

IdentifierTypeStateIssuer
000000368846OtherINPMC ANTHEM
0000000368824OtherINCSC ANTHEM

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
71001894AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Spine Care Past Accepting new patients
Pain Management Center of Southern Indiana, Inc. Past Accepting new patients
Pain Management Center of Southern Indiana Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jstevenson@yourcarecommunity.org

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649265869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5635",
            "address_2": "ATTN: MARIA MITCHELL",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474075635",
            "telephone_number": "812-337-5003",
            "fax_number": "812-337-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MCINTYRE DR",
            "address_2": "SUITE 150",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034221",
            "telephone_number": "812-333-7246",
            "fax_number": "812-333-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JANIS",
        "middle_name": "FARQUHAR",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71001894A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMC ANTHEM",
            "identifier": "000000368846",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSC ANTHEM",
            "identifier": "0000000368824",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.