Active NPI
Tana Willibey
- Gerontology Nurse Practitioner
- Indianapolis, IN
National Provider Identifier
1851068969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 28252242A
- Practice address
- 2231 Valley Point PL Apt 1536
Indianapolis, IN 46217-2256 - Phone
- (260) 624-5799
- NPI assigned
- Aug 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 28252242A | IN | Primary |
Addresses
Primary practice location
2231 Valley Point PL Apt 1536
Indianapolis, IN 46217-2256
Mailing address
2231 Valley Point PL Apt 1536
Indianapolis, IN 46217-2256
Phone (260) 624-5799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28252242A | IN | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1851068969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2231 VALLEY POINT PL APT 1536",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462172256",
"telephone_number": "260-624-5799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2231 VALLEY POINT PL APT 1536",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462172256",
"telephone_number": "260-624-5799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIBEY",
"first_name": "TANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "IN",
"license": "28252242A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.