Individual provider Active NPI

Ellery Anne Beard

  • Women's Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1831853712
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
71011942A Issued in IN
Practice address
7120 Clearvista Dr Ste 5100
Indianapolis, IN 46256-1868
Phone
(317) 621-9210
Fax
(317) 621-9211
NPI assigned
Oct 26, 2021
Last updated
May 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 71011942A IN Primary

Addresses

Primary practice location

7120 Clearvista Dr Ste 5100
Indianapolis, IN 46256-1868

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

533 E County Line Rd Ste 102
Greenwood, IN 46143-1074
Phone (317) 497-6626

Other identifiers 1

IdentifierTypeStateIssuer
300128573MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Greenwood

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
I20220223001590 IN Practitioner - Nurse Practitioner 3375937006 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71011942AINMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1831853712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 CLEARVISTA DR STE 5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561868",
            "telephone_number": "317-621-9210",
            "fax_number": "317-621-9211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "533 E County Line Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461431074",
            "country_code": "US",
            "telephone_number": "317-497-6626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEARD",
        "first_name": "ELLERY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "71011942A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300128573",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Greenwood",
            "affiliation": "N",
            "address_1": "533 E County Line Rd Ste 102",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.