Individual provider Active NPI

Krystin Chanelle Sheridan, ANP

  • Adult Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1730448622
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71003987A Issued in IN
Practice address
8433 Harcourt Rd Ste 100
Indianapolis, IN 46260
Phone
(317) 583-7600
NPI assigned
May 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71003987A IN
Adult Health Nurse Practitioner 363LA2200X 71003987A IN Primary

Addresses

Primary practice location

8433 Harcourt Rd Ste 100
Indianapolis, IN 46260

Mailing address

8433 Harcourt Rd Ste 100
Indianapolis, IN 46260-2193

Other identifiers 1

IdentifierTypeStateIssuer
201077320MedicaidIN

Other names 1

  • Krystin Chanelle Hutchison Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krystin.hutchison.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

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
I20120718000735 IN Practitioner - Nurse Practitioner 1052577020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

305 S Berkley Rd
Suite 100
Kokomo, IN 46901-5114
Phone (765) 236-8120

313 S Berkley Rd
Suite 120
Kokomo, IN 46901-5114
Phone (765) 236-8750

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

9166 E US Hwy 36
Avon, IN 46123-7772
Phone (317) 583-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003987AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Current Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jun 17, 2012 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jun 17, 2012 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

141 W 22nd St
Ste 214
Anderson, IN 46016
Phone (765) 643-7385

9166 E US Highway 36
Avon, IN 46123
Phone (317) 415-5300

13450 N Meridian St
Ste 135
Carmel, IN 46032
Phone (317) 582-9355

10590 N Meridian St
Ste 105
Carmel, IN 46290
Phone (317) 583-7800

13450 N Meridian St
Ste 160
Carmel, IN 46032
Phone (317) 582-7676

8333 Naab Rd
Ste 400
Indianapolis, IN 46260
Phone (317) 338-5066

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

313 S Berkley Rd
#120
Kokomo, IN 46901
Phone (765) 236-8750

1310 S Lebanon St
Ste B
Lebanon, IN 46052
Phone (317) 583-7627

1000 N 16th St
#230
New Castle, IN 47362
Phone (765) 521-2300

1000 N 16th St
Ste 230
New Castle, IN 47362
Phone (765) 599-3435

Interoperability endpoints

  • Direct secure messaging: krystin.hutchison.1@7598.direct.athenahealth.com

Organizations & group practices 4

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1730448622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-583-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "KRYSTIN",
        "middle_name": "CHANELLE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71003987A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71003987A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201077320",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krystin.hutchison.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8433 Harcourt Rd Ste 100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRYSTIN",
            "last_name": "HUTCHISON",
            "middle_name": "CHANELLE",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.