Individual provider Active NPI

Jennifer Ann Grossi, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1669019717
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71003801 Issued in IN
Practice address
705 Riley Hospital Dr
Ri 1134
Indianapolis, IN 46202-5109
Phone
(317) 944-8906
Fax
(317) 944-9330
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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 71003801 IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Ri 1134
Indianapolis, IN 46202-5109

Mailing address

PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 777-6435

Other names 1

  • Jennifer Ann Maddox 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
I20201116000750 IN Practitioner - Nurse Practitioner 7214348614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Pediatric Associates IncGroup PAC ID 2163326794, 100 clinicians

Practice addresses (Care Compare)

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 944-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003801INMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. CurrentSince Aug 14, 2020 Accepting new patients
Iu Health Medical Group, LLC Past Accepting new patients

Locations

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

4935 W Arlington Rd
Bloomington, IN 47404
Phone (812) 353-3743

11725 Illinois St
Ste 450
Carmel, IN 46032
Phone (317) 688-5700

11700 N Meridian St
Carmel, IN 46032
Phone (317) 688-2000

11590 N Meridian St
Ste 300
Carmel, IN 46032
Phone (317) 944-8906

11725 Illinois St
Ste 240
Carmel, IN 46032
Phone (317) 814-4590

2325 18th St
Ste 210
Columbus, IN 47201
Phone (812) 375-0272

415 E Cook Rd
Ste 300
Fort Wayne, IN 46825
Phone (317) 944-6201

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

8820 S Meridian St
Indianapolis, IN 46217
Phone (317) 865-6700

575 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 944-3966

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

705 Riley Hospital Dr
#1134
Indianapolis, IN 46202
Phone (317) 944-8906

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

200 N Tillotson Ave
Muncie, IN 47304
Phone (765) 286-8888

1434 Chester Blvd
Richmond, IN 47374
Phone (765) 966-1600

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

221 S 6th St
Terre Haute, IN 47807
Phone (812) 242-3157

Interoperability endpoints

  • Direct secure messaging: jgrossi@direct.iuhealth.org

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": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1669019717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "RI 1134",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-8906",
            "fax_number": "317-944-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSI",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71003801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MADDOX",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.