Jeremy Keith Nivens, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71005349A Issued in IN

Practice address

2155 E Main St
Plainfield, IN 46168-1816

Phone

(855) 297-9689

Fax

(603) 451-6001

NPI assigned

May 4, 2007

Sex

Male

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 1

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optima Dermatology LLCGroup PAC ID 3971561648, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hendricks Regional Health Hospital, Danville, IN, CCN 150005
• Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jnivens7267@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.

• Optima Dermatology LLC

  • Dermatology Physician
  • Boardman, OH
  • NPI 1831187764

  IN

  Medicare reassignment Care Compare group NPD
• Dermatology Center of Indiana PC

  • Dermatology Physician
  • Plainfield, IN
  • NPI 1033199138
  Medicare reassignment NPD
• Advanced Dermatology and Skin Cancer Center

  • Clinical Medical Laboratory
  • Boardman, OH
  • NPI 1497912893
  NPD (past)

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

• Hendricks County Hospital

  • General Acute Care Hospital
  • Danville, IN
  • NPI 1669475950
  Care Compare affiliation
• Union Hospital Inc.

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1619975331
  Care Compare affiliation
• Union Hospital, Inc

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1821859752
  Care Compare affiliation

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1780896431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NEW HAMPSHIRE AVE STE 2",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012864",
            "telephone_number": "330-947-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E MAIN ST",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461681816",
            "telephone_number": "855-297-9689",
            "fax_number": "603-451-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6639 Whitestown Pkwy",
            "address_purpose": "LOCATION",
            "city": "Zionsville",
            "state": "IN",
            "postal_code": "460777622",
            "country_code": "US",
            "telephone_number": "317-732-8980",
            "fax_number": "317-732-8979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032217",
            "country_code": "US",
            "telephone_number": "812-200-2458",
            "fax_number": "930-200-8590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 S State Road 135 Ste 250",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461436223",
            "country_code": "US",
            "telephone_number": "317-300-1788",
            "fax_number": "317-743-8103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIVENS",
        "first_name": "JEREMY",
        "middle_name": "KEITH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005349A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28198910A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Plainfield, IN
• Providers in Plainfield, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.