NPIMap

Individual provider Active NPI

Kristi Jo Nissley, FNP-C

  • Family Nurse Practitioner
  • Mitchell, IN
National Provider Identifier
1811225717
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003156A Issued in IN
Practice address
2759 State Road 37
Mitchell, IN 47446
Phone
(812) 849-6420
NPI assigned
Dec 3, 2009
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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 71003156A IN Primary

Addresses

Primary practice location

2759 State Road 37
Mitchell, IN 47446

Mailing address

2759 State Road 37
Mitchell, IN 47446-6016
Phone (812) 992-5440

Other practice location 1

629 Lincoln Ave
Bedford, IN 47421-2142
Phone (812) 675-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100318000323 IN Practitioner - Nurse Practitioner 3577698349 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

420 W Longest St
Paoli, IN 47454-8821
Phone (812) 723-3944

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
FC Indiana, LLC CurrentSince Jan 20, 2020 Accepting new patients
Southern Indiana Community Health Care, Inc CurrentSince May 13, 2023 Accepting new patients
Southern Indiana Community Health Care, Inc Current Accepting new patients
Southern Indiana Community Health Care, Inc CurrentSince May 13, 2023 Accepting new patients
FC Indiana, LLC CurrentSince Jan 20, 2020 Accepting new patients
Southern Indiana Community Health Care, Inc Past Accepting new patients
Southern Indiana Community Health Care, Inc Past Accepting new patients

Locations

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

629 Lincoln Ave
Bedford, IN 47421
Phone (812) 277-1702

2759 State Road 37
Mitchell, IN 47446
Phone (812) 849-6420

420 W Longest St
Paoli, IN 47454
Phone (812) 723-3944

1202 E Tipton St
Seymour, IN 47274
Phone (812) 627-4933

Interoperability endpoints

  • Direct secure messaging: kristinissley@sichc.allscriptsdirect.net

Organizations & group practices 9

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 4

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": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1811225717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 STATE ROAD 37",
            "city": "MITCHELL",
            "state": "IN",
            "postal_code": "474466016",
            "telephone_number": "812-992-5440",
            "fax_number": "812-992-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 STATE ROAD 37",
            "city": "MITCHELL",
            "state": "IN",
            "postal_code": "47446",
            "telephone_number": "812-849-6420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "629 Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IN",
            "postal_code": "474212142",
            "country_code": "US",
            "telephone_number": "812-675-4470",
            "fax_number": "812-675-4469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISSLEY",
        "first_name": "KRISTI",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-03",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003156A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, IN

Sources for this page

Verify at the official NPI Registry.