Individual provider Active NPI

Robin L Petit, FNP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1851931000
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28120871A Issued in IN
Practice address
6925 S Harding St Ste B-1
Indianapolis, IN 46217-4114
Phone
(317) 497-6140
NPI assigned
Jan 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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 28120871A IN Primary

Addresses

Primary practice location

6925 S Harding St Ste B-1
Indianapolis, IN 46217-4114

Mailing address

602 York Cir
Noblesville, IN 46062-9064
Phone (765) 215-1139

Other names 1

  • Robin Templin Former name

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
I20210429001435 IN Practitioner - Nurse Practitioner 3375952518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

13050 Parkside Dr
Suite 101
Fishers, IN 46038-8247
Phone (317) 621-2890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28120871AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Apr 28, 2021 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Apr 28, 2021 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

13050 Parkside Dr
Ste 101
Fishers, IN 46038
Phone (317) 621-2290

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • Direct secure messaging: rpetit394933@ecommunitydirect.com

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": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1851931000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 YORK CIR",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460629064",
            "telephone_number": "765-215-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6925 S HARDING ST STE B-1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462174114",
            "telephone_number": "317-497-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIT",
        "first_name": "ROBIN",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28120871A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "TEMPLIN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.