Individual provider Active NPI

Casey Detwiler, NP

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1982304077
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71014059A Issued in IN
Practice address
7979 N Shadeland Ave Ste 200
Indianapolis, IN 46250-2042
Phone
(317) 621-3300
Fax
(317) 621-6601
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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 28232046A IN
Gerontology Nurse Practitioner 363LG0600X 71014059A IN Primary

Addresses

Primary practice location

7979 N Shadeland Ave Ste 200
Indianapolis, IN 46250-2042

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

3132 River Bay Dr N
Indianapolis, IN 46240-2982
Phone (317) 800-1483

Other practice location 2

1629 Medical Arts Blvd Ste 120
Anderson, IN 46011-3454
Phone (765) 298-4220

Other identifiers 1

IdentifierTypeStateIssuer
300077628MedicaidIN

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
I20230711004277 IN Practitioner - Nurse Practitioner 4789043563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
Community Physician Network Specialty Care LLCGroup PAC ID 9931697265, 260 clinicians

Practice addresses (Care Compare)

1629 Medical Arts Blvd
Suite 120
Anderson, IN 46011-3454
Phone (765) 298-4220

8075 N Shadeland Ave
Indianapolis, IN 46250-2693
Phone (317) 621-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28232046AINMDRegistered Nurse
71014059AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physician Network Specialty Care LLC CurrentSince Nov 24, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 24, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 24, 2023 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

5918 Reliable Pkwy
Chicago, IL 60686

1629 Medical Arts Blvd
#120
Anderson, IN 46011
Phone (765) 298-2400

7979 N Shadeland Ave
Ste 200
Indianapolis, IN 46250
Phone (317) 621-3300

8075 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-8000

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: ckress170595@ecommunitydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1982304077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7979 N SHADELAND AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502042",
            "telephone_number": "317-621-3300",
            "fax_number": "317-621-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3132 River Bay Dr N",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462402982",
            "country_code": "US",
            "telephone_number": "317-800-1483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 Medical Arts Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460113454",
            "country_code": "US",
            "telephone_number": "765-298-4220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "CASEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28232046A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71014059A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300077628",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.