Individual provider Active NPI

Jody Lynn Root, FNP-BC

  • Family Nurse Practitioner
  • Bloomfield, IN
National Provider Identifier
1881622900
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71002130A Issued in IN
Practice address
10858 E State Road 54
Suite #1
Bloomfield, IN 47424-6069
Phone
(812) 400-0067
Fax
(812) 400-0067
NPI assigned
Jun 29, 2006
Last updated
Jun 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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 71002130A IN Primary

Addresses

Primary practice location

10858 E State Road 54
Suite #1
Bloomfield, IN 47424-6069

Mailing address

10858 E State Road 54
Suite #1
Bloomfield, IN 47424-6069
Phone (812) 400-0067

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
I20070604000404 IN Practitioner - Nurse Practitioner 1254439946 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westgate Medical LLCGroup PAC ID 3274846381, 2 clinicians

Practice addresses (Care Compare)

10858 E St Rd
54 Suite 1
Bloomfield, IN 47424-6069
Phone (812) 400-0067

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71002130AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael S. Miller DO, Facos, CWS, PC CurrentSince Sep 8, 2018 Accepting new patients
Westgate Medical, LLC Family CurrentSince Sep 17, 2013 Accepting new patients

Locations

10858 E State Road 54
#1
Bloomfield, IN 47424
Phone (812) 400-0067

3850 Shore Dr
Ste 315
Indianapolis, IN 46254
Phone (317) 429-0061

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 3

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1881622900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10858 E STATE ROAD 54",
            "address_2": "SUITE #1",
            "city": "BLOOMFIELD",
            "state": "IN",
            "postal_code": "474246069",
            "telephone_number": "812-400-0067",
            "fax_number": "812-400-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10858 E STATE ROAD 54",
            "address_2": "SUITE #1",
            "city": "BLOOMFIELD",
            "state": "IN",
            "postal_code": "474246069",
            "telephone_number": "812-400-0067",
            "fax_number": "812-400-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002130A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, IN

Sources for this page

Verify at the official NPI Registry.