Individual provider Active NPI

Noelle C Lottes, RN FNP

  • Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1730113606
Registry record updated Jul 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001576A Issued in IN
Practice address
938 Mezzanine Dr Ste B
Lafayette, IN 47905-8641
Phone
(765) 742-1533
Fax
(765) 742-1824
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001576A IN Primary

Addresses

Primary practice location

938 Mezzanine Dr Ste B
Lafayette, IN 47905-8641

Mailing address

2105 Windflower PL
West Lafayette, IN 47906-6616
Phone (765) 441-2096

Other identifiers 2

IdentifierTypeStateIssuer
000000599459OtherINANTHEM PROVIDER NUMBER
200852880MedicaidIN

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
I20090410000090 IN Practitioner - Nurse Practitioner 7618024506

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001576AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neo Vision PC PastSince Jan 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: noelle.lottes.1@27870.direct.athenahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689379200000",
    "number": "1730113606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 WINDFLOWER PL",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479066616",
            "telephone_number": "765-441-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 MEZZANINE DR STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479058641",
            "telephone_number": "765-742-1533",
            "fax_number": "765-742-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTTES",
        "first_name": "NOELLE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "RN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-07-15",
        "certification_date": "2023-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001576A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000599459",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200852880",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.