Active NPI
Sue Ellyn Nottingham, FNP
- Family Nurse Practitioner
- Fishers, IN
National Provider Identifier
1891853644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71000515
- Practice address
- 11530 Allisonville Rd Ste 100
Fishers, IN 46038-1862 - Phone
- (317) 415-5900
- NPI assigned
- Dec 5, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000515 | IN | Primary |
Addresses
Primary practice location
11530 Allisonville Rd Ste 100
Fishers, IN 46038-1862
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200252080 | Medicaid | IN | |
| 000000666143 | Other | IN | BLUE CROSS |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000515 | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508976000000",
"number": "1891853644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 N MERIDIAN ST # 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462901024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11530 ALLISONVILLE RD STE 100",
"city": "FISHERS",
"state": "IN",
"postal_code": "460381862",
"telephone_number": "317-415-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOTTINGHAM",
"first_name": "SUE",
"middle_name": "ELLYN",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2017-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71000515",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200252080",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000000666143",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.