Diane Lynn Brackin, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71005606A Issued in IN

Practice address

9894 E 121St St
Fishers, IN 46037-4154

Phone

(317) 621-4900

NPI assigned

Jan 31, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Diane Lynn Smith Former name

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Community Physician Network Specialty Care LLCGroup PAC ID 9931697265, 260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital East Hospital, Indianapolis, IN, CCN 150074
• Community Hospital North Hospital, Indianapolis, IN, CCN 150169

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dsmith6209@ecommunitydirect.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.

• Community Physician Network Specialty Care LLC

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1588535496
  Medicare reassignment Care Compare group NPD
• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment Care Compare group NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Care Compare affiliation
• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1619163854
  Care Compare affiliation

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

{
    "created_epoch": "1422662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1730579525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9894 E 121ST ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374154",
            "telephone_number": "317-621-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKIN",
        "first_name": "DIANE",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-31",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71005606A",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IN",
            "license": "28124384A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01512462",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201313080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "SMITH",
            "middle_name": "LYNN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Boyd Physical Therapy & Wellness LLC
• Brianna Boyd
• Cederia Boykin, LSW
• Braces for U
• Stefanie L Bracken, PT, DPT
• Amanda L Bradburn
• Makenna Payge Bradley
• Cherone Bradshaw
• Rayshawn Sierra Bradshaw
• Sheldon Brady

• Gerontology Nurse Practitioner in Fishers, IN
• Providers in Fishers, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.