Active NPI
Penni Lorraine Cremer, PMHCNS-BC
- Clinical Nurse Specialist
- Indianapolis, IN
National Provider Identifier
1710944863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 70000131A
- Practice address
- 1424 E 91St St
Indianapolis, IN 46240-1902 - Phone
- (317) 709-3365
- NPI assigned
- May 1, 2006
- 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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 70000131A | IN | Primary |
Addresses
Primary practice location
1424 E 91St St
Indianapolis, IN 46240-1902
Mailing address
12539 Pebblepointe Pass
Carmel, IN 46033
Phone (317) 709-3365
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200405980 | Medicaid | IN |
Other names 1
- Penni Lorraine Fuqua
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
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70000131A | IN | MD | Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Hedgehog Psychiatric | Clinical Nurse Specialist | Past | Accepting new patients |
| Indiana Health Group Inc | Past | Accepting new patients |
Interoperability endpoints
- pcremer75332@direct.eskenazihealth.edu
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.
-
- Clinical Nurse Specialist
- Indianapolis, IN
- NPI 1093760951
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Carmel, IN
- NPI 1356396295
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1710944863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12539 PEBBLEPOINTE PASS",
"city": "CARMEL",
"state": "IN",
"postal_code": "46033",
"telephone_number": "317-709-3365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 E 91ST ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462401902",
"telephone_number": "317-709-3365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREMER",
"first_name": "PENNI",
"middle_name": "LORRAINE",
"name_prefix": "Mrs.",
"credential": "PMHCNS-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "IN",
"license": "70000131A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200405980",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PENNI",
"last_name": "FUQUA",
"middle_name": "LORRAINE",
"credential": "PMHCNS-BC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.