Individual provider Active NPI

David M Jette, NP

  • Family Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1962036715
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009892A Issued in IN
Practice address
601 W 2ND St
Bloomington, IN 47403-2317
Phone
(812) 353-9515
NPI assigned
Mar 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28222838A IN
Family Nurse Practitioner 363LF0000X 71009892A IN Primary

Addresses

Primary practice location

601 W 2ND St
Bloomington, IN 47403-2317

Mailing address

601 W 2ND St
Bloomington, IN 47403-2317

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
I20200508002542 IN Practitioner - Nurse Practitioner 2466883376 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians
Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

150 W Market St
Suite 400
Indianapolis, IN 46204-2810
Phone (855) 743-2247

8398 Mississippi St
FL 2
Merrillville, IN 46410-6316
Phone (855) 743-2247

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28222838AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Ecs, Inc CurrentSince Dec 19, 2024 Accepting new patients
Eventus WH Midwest Care, LLC CurrentSince Oct 1, 2025 Accepting new patients
Eventus Ecs - Kentucky, PLLC CurrentSince Nov 1, 2025 Accepting new patients
Extended Care Specialists, Inc Family CurrentSince Jan 1, 2022 Accepting new patients

Locations

2100 Midway St
Columbus, IN 47201
Phone 3178181240225

3512 Stellhorn Rd
Fort Wayne, IN 46815

3815 River Crossing Pkwy
Ste 100
Indianapolis, IN 46240
Phone (317) 218-3479

150 W Market St
Ste 400
Indianapolis, IN 46204

8398 Mississippi St
Fl 2
Merrillville, IN 46410

Organizations & group practices 4

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": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1962036715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032317",
            "telephone_number": "812-353-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTE",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28222838A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009892A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.