Patricia R Fettig, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71002768A Issued in IN

Practice address

10731 N State Road 13
Elwood, IN 46036-8874

Phone

(765) 552-5009

Fax

(765) 552-8347

NPI assigned

Oct 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Aspire Indiana Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
  • NPI 1124016050

  IN

  Medicare reassignment NPD
• Aspire Indiana Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Anderson, IN
  • NPI 1780068288

  IN

  Medicare reassignment

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1760633267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 E 148TH ST",
            "address_2": "SUITE 1",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604360",
            "telephone_number": "317-587-0500",
            "fax_number": "317-674-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10731 N STATE ROAD 13",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460368874",
            "telephone_number": "765-552-5009",
            "fax_number": "765-552-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTIG",
        "first_name": "PATRICIA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002768A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000802585",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201006170",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elwood Family Dentistry, LLC
• Elwood Family Medicine PC
• Everside Health, LLC
• Kerrie Felton
• Amber Ferree
• Gina Fike
• Julie F Foltz, BA
• Foot One Inc
• Foot One Mechanix
• Jordyn Leigh Fralick, RBT

• All providers in Elwood, IN
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.