Active NPI
Jodi Bult, N.P.
- Adult Health Nurse Practitioner
- Dyer, IN
National Provider Identifier
1669447900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 071004325A
- Practice address
- 15900 W 101St Ave
Dyer, IN 46311-3065 - Phone
- (219) 365-6333
- Fax
- (219) 365-8291
- NPI assigned
- Feb 21, 2006
- Last updated
- Apr 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 071004325A | IN | Primary |
Addresses
Primary practice location
15900 W 101St Ave
Dyer, IN 46311-3065
Mailing address
15900 W 101St Ave
Dyer, IN 46311-3065
Phone (219) 365-6333
Other practice location 1
16000 W 101st Ave
Dyer, IN 46311
Phone (219) 365-6333
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jodi.bult@mmgsc.eclinicaldirect.com | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15900 W 101St Ave
Dyer, IN 46311-3065
Phone (219) 365-6333
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071004325A | IN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marcotte Medical Group, PC | Current | Accepting new patients |
Locations
15900 W 101st Ave
Dyer, IN 46311
Phone (219) 365-6333
15900 W 101st Ave
#0
Dyer, IN 46311
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EBFGAA
- jodi.bult@mmgsc.eclinicaldirect.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Marcotte Medical Group, SC
- Family Medicine Physician
- Dyer, IN
- NPI 1669424768
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Powers Health Rehabilitation Center
- Rehabilitation Hospital
- Crown Point, IN
- NPI 1801301437
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Crown Point, IN
- NPI 1336205798
-
dba Franciscan Health Dyer
- General Acute Care Hospital
- Dyer, IN
- NPI 1811077431
-
- General Acute Care Hospital
- Munster, IN
- NPI 1427493246
-
dba Community Hospital
- General Acute Care Hospital
- Munster, IN
- NPI 1003918210
-
dba Northwestern Medicine Central Dupage Hospital
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
dba Northwestern Medicine Central Dupage Hospital
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1669447900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15900 W 101ST AVE",
"city": "DYER",
"state": "IN",
"postal_code": "463113065",
"telephone_number": "219-365-6333",
"fax_number": "219-365-8291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15900 W 101ST AVE",
"city": "DYER",
"state": "IN",
"postal_code": "463113065",
"telephone_number": "219-365-6333",
"fax_number": "219-365-8291"
}
],
"practiceLocations": [
{
"address_1": "16000 W 101st Ave",
"address_purpose": "LOCATION",
"city": "Dyer",
"state": "IN",
"postal_code": "46311",
"country_code": "US",
"telephone_number": "219-365-6333",
"fax_number": "219-365-8291",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULT",
"first_name": "JODI",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-21",
"last_updated": "2021-04-08",
"certification_date": "2021-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IN",
"license": "071004325A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jodi.bult@mmgsc.eclinicaldirect.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "15900 W 101st Ave",
"city": "Dyer",
"state": "IN",
"country_code": "US",
"postal_code": "463113065",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dyer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.