Heather Stultz, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10000754A Issued in IN

Practice address

1402 E County Line Rd
Indianapolis, IN 46227-0963

Phone

(317) 621-5700

NPI assigned

Jun 5, 2006

Last updated

May 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hstultz168960@ecommunitydirect.com

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Medical Associates

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1710932736
  Medicare reassignment
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Emergency Medicine of Indiana

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1952356883
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1710926092",
    "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": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 E COUNTY LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462270963",
            "telephone_number": "317-621-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1664 W Smith Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461421550",
            "country_code": "US",
            "telephone_number": "317-887-7640",
            "fax_number": "317-887-7664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 N Ritter Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462193027",
            "country_code": "US",
            "telephone_number": "317-355-5041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULTZ",
        "first_name": "HEATHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000754A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01512441",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201292730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pratima V Stuhldreher, MD
• Samuel L Stukey, PHARMD
• Craig Allen Stull, ATC
• Kimberly Sue Stull, NP
• Emily Anne Stults, FNP-C
• Kristian Stultz
• Anne J Stump, MD
• Corey Stump, DO
• Melissa Stump, DPT
• Kenneth P Stumpf, D.P.M.

• Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.