Active NPI
Alexis Renae Hodupp
- Primary Care Nurse Practitioner
- Greentown, IN
National Provider Identifier
1952173247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 71014016A
- Practice address
- 115 W Main St
Greentown, IN 46936-1116 - Phone
- (765) 627-4003
- NPI assigned
- Oct 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 71014016A | IN | Primary |
Addresses
Primary practice location
115 W Main St
Greentown, IN 46936-1116
Mailing address
115 W Main St
Greentown, IN 46936-1116
Phone (765) 627-4003
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71014016A | IN | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1952173247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 W MAIN ST",
"city": "GREENTOWN",
"state": "IN",
"postal_code": "469361116",
"telephone_number": "765-627-4003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W MAIN ST",
"city": "GREENTOWN",
"state": "IN",
"postal_code": "469361116",
"telephone_number": "765-627-4003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODUPP",
"first_name": "ALEXIS",
"middle_name": "RENAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-30",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "IN",
"license": "71014016A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greentown, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.