Individual provider Active NPI

Amber M Butcher, FNPC

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1659713378
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004597A Issued in IN
Practice address
5150 Shelbyville Rd
Indianapolis, IN 46237-2601
Phone
(317) 782-1577
Fax
(888) 366-7577
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 28168131A IN
Family Nurse Practitioner 363LF0000X 28168131A IN
Family Nurse Practitioner 363LF0000X 71004597A IN Primary

Addresses

Primary practice location

5150 Shelbyville Rd
Indianapolis, IN 46237-2601

Mailing address

5150 Shelbyville Rd
Indianapolis, IN 46237-2601
Phone (317) 782-1577

Other identifiers 1

IdentifierTypeStateIssuer
201195550MedicaidIN

Other names 1

  • Amber M Jacobi Former name

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
I20140109000430 IN Practitioner - Nurse Practitioner 8426286881 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28168131AINMDFamily Nurse Practitioner
71004597AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hancock Health Gateway Services Inc CurrentSince Feb 24, 2020 Accepting new patients
Indiana University Health Care Associates, Inc Family CurrentSince Oct 6, 2013 Accepting new patients
Indiana University Health Care Associates, Inc. CurrentSince Oct 6, 2013 Accepting new patients
Hancock Physician Network, LLC CurrentSince Feb 24, 2020 Accepting new patients
Hancock Health Gateway Services, Inc. Family CurrentSince Feb 24, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

124 W Muskegon Dr
Greenfield, IN 46140
Phone (317) 318-7471

6189 W John L Modglin Dr
Ste 101
Greenfield, IN 46140
Phone (317) 866-7300

801 N State St
Ste 2000
Greenfield, IN 46140
Phone (317) 325-2727

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Interoperability endpoints

  • Direct secure messaging: amber.butcher.2@14940.direct.athenahealth.com

Organizations & group practices 6

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1659713378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 SHELBYVILLE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462372601",
            "telephone_number": "317-782-1577",
            "fax_number": "888-366-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 SHELBYVILLE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462372601",
            "telephone_number": "317-782-1577",
            "fax_number": "888-366-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "AMBER",
        "middle_name": "M",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IN",
            "license": "28168131A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28168131A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004597A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201195550",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "JACOBI",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.