Individual provider Active NPI

Nicki Lorean Speck, FNP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1922827427
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71015881A Issued in IN
Practice address
2002 W 86TH St
Indianapolis, IN 46260-1903
Phone
(317) 872-8811
NPI assigned
Oct 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015881A IN
Primary Care Nurse Practitioner 363LP2300X 71015881A IN
Nurse Practitioner 363L00000X 71015881A IN Primary

Addresses

Primary practice location

2002 W 86TH St
Indianapolis, IN 46260-1903

Mailing address

12433 Clark St Apt 102
Carmel, IN 46032-7677
Phone (317) 413-5373

Other practice location 1

11680 Commercial Dr
Fishers, IN 46038-2936
Phone (317) 436-8712

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
I20250516003217 IN Practitioner - Nurse Practitioner 5991223588 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71015881AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Nurse Practitioner CurrentSince May 5, 2025 Accepting new patients

Locations

155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437

2002 W 86th St
Indianapolis, IN 46260
Phone (317) 872-8811

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1922827427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12433 CLARK ST APT 102",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327677",
            "telephone_number": "317-413-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601903",
            "telephone_number": "317-872-8811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11680 Commercial Dr",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "460382936",
            "country_code": "US",
            "telephone_number": "317-436-8712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPECK",
        "first_name": "NICKI",
        "middle_name": "LOREAN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015881A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71015881A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71015881A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.