Pamela Jane Gutierrez, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Spencer, IN
NPI 1912661968 · NPPES record last updated Mar 12, 2022
Key facts
- NPI
- 1912661968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71012361A (IN)
- Practice address
- 279 W Hillside Ave
Spencer, IN 47460-1201 - Phone
- (812) 829-4437
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Limestone Treatment and Healing Center LLC
Practice addresses (Care Compare)
1535 G St
Bedford, IN 47421-3827
Phone (812) 277-6520
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220323002340 | IN | Practitioner - Nurse Practitioner | 9638564917 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71012361A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FC Indiana, LLC | Current |
Accepting new patients | |
| Little Clinic of in LLC | Family | Current |
Accepting new patients |
| Mid-South Home Care Services, LLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Mid-South Home Care Services, LLC | Current |
Accepting new patients | |
| FC Indiana, LLC | Current |
Accepting new patients |
Locations
2418 16th St
Bedford, IN 47421
Phone (812) 278-3154
1175 S College Mall Rd
Bloomington, IN 47401
Phone (812) 323-4301
815 Highlander Point Dr
Floyds Knobs, IN 47119
Phone (812) 923-7146
4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510
9775 Crosspoint Blvd
Ste 118
Indianapolis, IN 46256
Phone (317) 381-0095
655 Brawley School Rd
Ste 200
Mooresville, NC 28117
Interoperability endpoints
- pamela.gutierrez@krogerhealth.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | IN | ||
| Family Nurse Practitioner | 363LF0000X | 71012361A | IN | Yes |
Addresses
Primary practice location
279 W Hillside Ave
Spencer, IN 47460-1201
Mailing address
279 W Hillside Ave
Spencer, IN 47460-1201
Phone (812) 829-4437
Other providers in Spencer, IN
- Julia M. Fine
- Emme French
- Samantha Jo Fritch
- Jocelyn Elaine Frye
- Green Dental of Owen County
- Jenna Hendershot
- Julianna M Holmes
- Hook-Superx LLC
- Indiana Health Centers, Inc
- Indiana University Health Bloomington Inc
All providers in Spencer, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.