Individual provider Active NPI

Debra Hermann

  • Family Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1992345201
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009686A Issued in IN
Practice address
3900 S Walnut St
Bloomington, IN 47401-7325
Phone
(812) 822-1516
NPI assigned
Jan 14, 2020
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71009686A IN
Family Nurse Practitioner 363LF0000X 71009686A IN Primary

Addresses

Primary practice location

3900 S Walnut St
Bloomington, IN 47401-7325

Mailing address

6462 S McQuillen LN
Owensburg, IN 47453-8229
Phone (812) 369-5471

Other practice location 1

10858 E State Road 54
Bloomfield, IN 47424-6069
Phone (812) 400-0067

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
I20210226000425 IN Practitioner - Nurse Practitioner 1658786587 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71009686AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince May 22, 2024 Accepting new patients
FC Indiana, LLC Nurse Practitioner CurrentSince Nov 15, 2022 Accepting new patients
Cep America LLC Current Accepting new patients
Inphynet Primary Care Physicians Midwest, S.C. Nurse Practitioner CurrentSince Mar 22, 2022 Accepting new patients
Cep America LLC CurrentSince May 22, 2024 Accepting new patients
FC Indiana, LLC CurrentSince Nov 15, 2022 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

2418 16th St
Bedford, IN 47421
Phone (812) 278-3154

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

1202 E Tipton St
Seymour, IN 47274
Phone (812) 627-4933

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1992345201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6462 S MCQUILLEN LN",
            "city": "OWENSBURG",
            "state": "IN",
            "postal_code": "474538229",
            "telephone_number": "812-369-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 S WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474017325",
            "telephone_number": "812-822-1516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10858 E State Road 54",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "IN",
            "postal_code": "474246069",
            "country_code": "US",
            "telephone_number": "812-400-0067",
            "fax_number": "812-400-0017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERMANN",
        "first_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009686A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009686A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.