Glenda Jackson Prabu

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71012779A Issued in IN

Practice address

13400 N Meridian St Ste 302
Carmel, IN 46032-7104

Phone

(317) 415-6050

NPI assigned

Jun 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glenda.prabu.1@7598.direct.athenahealth.com

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.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  Family

  Medicare reassignment Care Compare group NPD
• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Carmel, IN
  • NPI 1558130922
  Medicare reassignment NPD
• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Carmel, IN
  • NPI 1538938709
  Medicare reassignment NPD
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Gary, IN
  • NPI 1528311149

  Nurse Practitioner

  Medicare reassignment NPD
• SHC Medical Partners of Indiana, LLC

  • Nurse Practitioner
  • Carmel, IN
  • NPI 1407283781
  Medicare reassignment
• Midwest Post Acute Care PLLC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1083012074

  IN

  Medicare reassignment
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1184063257
  NPD
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Mishawaka, IN
  • NPI 1356687164
  NPD
• St. Vincent Medical Group, Inc.

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD
• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Texarkana, TX
  • NPI 1528871126
  NPD
• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Ridgeland, MS
  • NPI 1992518591
  NPD
• Transitional Care Physicians of Georgia PC

  • Specialist
  • Monroe, GA
  • NPI 1619317542
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Vincent Carmel Hospital, Inc.

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1639124134
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1720719065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 N MERIDIAN ST STE 302",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 N MERIDIAN ST STE 302",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327104",
            "telephone_number": "317-415-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON PRABU",
        "first_name": "GLENDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F07211173",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012779A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glenda.prabu.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "13400 N Meridian St Ste 302",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460327104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glenda.prabu.1@7598.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "13400 N Meridian St Ste 302",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460327104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sydney Beth Isley
• Mohamed M Issak
• J Herschberger LLC
• Ali Jabbari
• Stanley C. Jachimowicz, DDS
• Erin Colleen Jackson
• Michelle N Jackson, SPEECH PATHOLOGIST
• Valerie Kaye Jackson, NP
• Dennis M Jacob, M.D.
• Trevor James Jacob, PT, DPT

• Family Nurse Practitioner in Carmel, IN
• Providers in Carmel, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.

Verify at the official NPI Registry.