Individual provider Active NPI

Kimberley L Jelinek Allen, FNP

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1841543543
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004188A Issued in IN
Practice address
5177 McCarty LN
Lafayette, IN 47905-8764
Phone
(765) 448-8000
NPI assigned
Oct 18, 2012
Last updated
Mar 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71004188A IN
Family Nurse Practitioner 363LF0000X 71004188A IN Primary

Addresses

Primary practice location

5177 McCarty LN
Lafayette, IN 47905-8764

Mailing address

1200 W White River Blvd
Muncie, IN 47303-4988
Phone (877) 668-5621

Other practice location 1

5177 McCarty Ln
Lafayette, IN 47905-8764
Phone (765) 448-8000

Other identifiers 2

IdentifierTypeStateIssuer
000001141160OtherINANTHEM PIN
201114680MedicaidIN

Other names 1

  • Kimberley L Jelinek Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjelinek@direct.iuhealth.org

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
I20121128000624 IN Practitioner - Nurse Practitioner 6709038631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3851 N River Rd
West Lafayette, IN 47906-3762
Phone (765) 463-1502

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71004188AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Indiana, Auditor of State CurrentSince Feb 8, 2024 Accepting new patients
Arnett Clinic, LLC CurrentSince Feb 1, 2018 Accepting new patients
State of Indiana Auditor of State CurrentSince Feb 8, 2024 Accepting new patients
Arnett Clinic, LLC CurrentSince Feb 1, 2018 Accepting new patients
State of Indiana, Auditor of State Current Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Major Hospital Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

2600 Greenbush St
Lafayette, IN 47904

5177 McCarty Ln
Lafayette, IN 47905
Phone (765) 838-7101

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

3851 N River Rd
West Lafayette, IN 47906
Phone (765) 463-1502

3851 N River Rd
Ofc
West Lafayette, IN 47906

Organizations & group practices 7

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 1

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1841543543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5177 MCCARTY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479058764",
            "telephone_number": "765-448-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5177 McCarty Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479058764",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-8544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JELINEK ALLEN",
        "first_name": "KIMBERLEY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004188A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004188A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000001141160",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201114680",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjelinek@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "5177 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "JELINEK",
            "middle_name": "L",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.