Individual provider Active NPI

Charity J Holtsclaw

  • Family Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1770247074
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011756A Issued in IN
Practice address
3211 W Reddy Way
Bloomington, IN 47403-4066
Phone
(812) 825-0777
Fax
(812) 825-3917
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011756A IN Primary

Addresses

Primary practice location

3211 W Reddy Way
Bloomington, IN 47403-4066

Mailing address

3211 W Reddy Way
Bloomington, IN 47403-4066
Phone (812) 825-0777

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
I20220204000847 IN Practitioner - Nurse Practitioner 3779976253 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monroe Medical Group IncGroup PAC ID 0446576680, 25 clinicians

Practice addresses (Care Compare)

3211 W Reddy Way
Bloomington, IN 47403-4066

421 S Landmark Ave
Bloomington, IN 47403-5003
Phone (812) 676-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71011756AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Medical Group Inc CurrentSince Nov 11, 2025 Accepting new patients
FC Indiana, LLC CurrentSince Jan 20, 2022 Accepting new patients
FC Indiana, LLC CurrentSince Jan 20, 2022 Accepting new patients
Harrison County Hospital CurrentSince Jun 1, 2022 Accepting new patients
Harrison County Hospital CurrentSince Jun 1, 2022 Accepting new patients

Locations

2418 16th St
Bedford, IN 47421
Phone (812) 278-3154

3211 W Reddy Way
Bloomington, IN 47403
Phone (812) 825-0777

421 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-4468

1263 Hospital Dr NW
Ste 250
Corydon, IN 47112
Phone (812) 738-4915

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

315 S Memorial Dr
New Castle, IN 47362
Phone (765) 518-8100

Interoperability endpoints

  • Direct secure messaging: charity.holtsclaw.1@8479.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8479/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1770247074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 W REDDY WAY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034066",
            "telephone_number": "812-825-0777",
            "fax_number": "812-825-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 W REDDY WAY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034066",
            "telephone_number": "812-825-0777",
            "fax_number": "812-825-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTSCLAW",
        "first_name": "CHARITY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011756A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.