Jonathan Notelle, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71006122A Issued in IN

Practice address

1721 Magnavox Way
Fort Wayne, IN 46804-1537

Phone

(260) 748-3650

Fax

(260) 748-3651

NPI assigned

Jan 25, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bon Secours Ambulatory Services - St. Francis, LLC

  • Urgent Care Clinic/Center
  • Greenville, SC
  • NPI 1124495643
  Medicare reassignment NPD
• Bon Secours Medical Group Greenville Specialty Care LLC

  • Cardiovascular Disease Physician
  • Greenville, SC
  • NPI 1821679580
  Medicare reassignment NPD
• Bon Secours Medical Group Greenville Specialty Care LLC

  • Orthopaedic Surgery Physician
  • Fountain Inn, SC
  • NPI 1760361174
  NPD
• Woodruff Road Urgent Care Center, P.C.

  • Urgent Care Clinic/Center
  • Easley, SC
  • NPI 1598073496
  NPD
• St Francis Physician Services Inc

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295769438
  NPD (past)

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1982061701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "HUNTERTOWN",
            "state": "IN",
            "postal_code": "467480670",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 MAGNAVOX WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041537",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2124 N Biomet Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465827858",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2512 E DuPont Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251609",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1314 E 7th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "IN",
            "postal_code": "467062533",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6811 Lima Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468181145",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOTELLE",
        "first_name": "JONATHAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28202205A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006122A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1003883",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201350810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Joseph Norton, M.D.
• Jonathan VN Norton, D.P.M.
• Rita L. Norton, LPN
• Robert J Norton, PT
• Ross Norton
• Nathan Notter, P.T.
• Maryam Noureldin, PHARMD, BCPS
• Mohamed Noureldin Birima Noureldin, MD
• Nova Physician Group PLLC
• Solomia Novachenko, RBT

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.