Individual provider Active NPI

Gwyndolen Morson, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1871964023
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71005921A Issued in IN
Practice address
401 E 34TH St
Indianapolis, IN 46205-3754
Phone
(317) 926-1507
Fax
(317) 926-1508
NPI assigned
Oct 14, 2015
Last updated
Jul 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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 71005921A IN Primary
Registered Nurse 163W00000X 28203742A IN

Addresses

Primary practice location

401 E 34TH St
Indianapolis, IN 46205-3754

Mailing address

401 E 34TH St
Indianapolis, IN 46205-3754
Phone (317) 926-1507

Other names 1

  • Gwyndolen Vicars 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
I20151123000091 IN Practitioner - Nurse Practitioner 7517267636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1702 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone (765) 625-5100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28203742AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Professionals Community Health Center, Inc. Current Accepting new patients
Valley Professionals Community Health Center, Inc. CurrentSince Jan 4, 2021 Accepting new patients
St. Clare Medical Center PastSince Nov 5, 2015 Accepting new patients

Locations

703 W Park St
Cayuga, IN 47928
Phone (765) 492-9042

777 S Main St
Ste 100
Clinton, IN 47842
Phone (765) 828-1003

1702 Lafayette Rd
Crawfordsvlle, IN 47933
Phone (765) 362-4400

727 N Lincoln Rd
Rockville, IN 47872
Phone (765) 569-1123

1530 N 7th St
Ste 201
Terre Haute, IN 47807
Phone (812) 238-7631

4757 S 7th St
Terre Haute, IN 47802
Phone (812) 234-2289

601 W National Ave
West Terre Haute, IN 47885
Phone (812) 244-1515

Organizations & group practices 3

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 2

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": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1871964023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 34TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053754",
            "telephone_number": "317-926-1507",
            "fax_number": "317-926-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 34TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053754",
            "telephone_number": "317-926-1507",
            "fax_number": "317-926-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORSON",
        "first_name": "GWYNDOLEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005921A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28203742A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWYNDOLEN",
            "last_name": "VICARS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.