Individual provider Active NPI

Krysta Graham, FNP-C

  • Family Nurse Practitioner
  • Fishers, IN
National Provider Identifier
1992291264
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008144A Issued in IN
Practice address
13121 Olio Rd Ste 300
Fishers, IN 46037-7240
Phone
(317) 621-1300
Fax
(317) 621-1310
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71008144A IN Primary

Addresses

Primary practice location

13121 Olio Rd Ste 300
Fishers, IN 46037-7240

Mailing address

14185 Avalon East Dr
Fishers, IN 46037-6201
Phone (317) 748-1072

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
I20180823002641 IN Practitioner - Nurse Practitioner 0941559983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

13050 Parkside Dr
Suite 101
Fishers, IN 46038-8247
Phone (317) 621-2890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71008144AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little Clinic of in LLC Family CurrentSince Jan 13, 2019 Accepting new patients
Major Hospital Past Accepting new patients
Indiana Pain and Injury Centers LLC PastSince Oct 20, 2019 Accepting new patients

Locations

1217 S Rangeline Rd
Carmel, IN 46032
Phone (317) 574-4680

11700 Olio Rd
Fishers, IN 46037
Phone (317) 436-4950

815 Highlander Point Dr
Floyds Knobs, IN 47119
Phone (812) 923-7146

Interoperability endpoints

  • Direct secure messaging: kgraham461271@ecommunitydirect.com

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.

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": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1992291264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14185 AVALON EAST DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460376201",
            "telephone_number": "317-748-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13121 OLIO RD STE 300",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377240",
            "telephone_number": "317-621-1300",
            "fax_number": "317-621-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KRYSTA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008144A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.