EMMA JOY NORDSTROM (MD) – Family Medicine Physician, NPI 1003136011

Family Medicine Physician

EMMA JOY NORDSTROM (MD) is a healthcare provider. based in Lebanon, Indiana. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 01070698A (IN). The NPI Number for EMMA JOY NORDSTROM (MD) is 1003136011

Main info

Female

16 Years Of Experience

Accepts Medicare Assignment

Name

EMMA JOY NORDSTROM (MD)

NPI

1003136011

Phone

(765) 485-8649

Address

2705 N LEBANON ST STE 300

Enumeration Date

2 June 2010

Last Update Date

11 October 2023

Doctor Profile

Medical School Name

INDIANA UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

7653350123

Graduation Year

2010 (16 years ago)

PAC ID

3173775699

Group Practice PAC ID

4082523170

Professional Enrollment ID

I20121210000140

Address ID

IN460529497LE400XXRDXX500

Telehealth

Yes

Contacts

Secure Messaging

emma.nordstrom@whs.eclinicaldirectplus.com

Secure Messaging

enordstrom@withamdirect.org

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience56

Completeness85

Years active:16State licenses:1Other namesUpdated within 12 months

2,861 FAMILY PRACTICE in IN

Provider Addresses for EMMA JOY NORDSTROM (MD)

2705 N LEBANON ST STE 300
LEBANON, IN 460528622
Phone: (765) 485-8649
Fax: (765) 485-8650
Type: Location
2705 N LEBANON ST STE 305
LEBANON, IN 460528622
Phone:
Type: Mailing
2605 N LEBANON ST
LEBANON, IN 460521476
Phone:
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 216 Open Payments records for all available years, with a total value of $3,525.

Total Amount is formed as General ($3,525) + Research ($0) + Ownership ($0) = $3,525.

Last reported payment date: 2024-12-27 • Largest payer in this snapshot: ABBVIE INC. ($706).

Total Amount

$3,525

General + Research + Ownership

Payments

216

Total payment records

General Amount

$3,525

General payments

Research Amount

Research funding

Ownership Amount

Ownership interests

Ownership Count

Ownership records

Last Payment Date

2024-12-27

Latest reported date

Top Companies

Largest payers in this snapshot

Company	Amount
ABBVIE INC.	$706
Amgen Inc.	$408
GlaxoSmithKline, LLC.	$333
Lilly USA, LLC	$300
Bayer Healthcare Pharmaceuticals Inc.	$162

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-12-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20121210000140	I	Family Practice	IN	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCS	Description	Services	Beneficiaries	Medicare allowed
J0897	Injection, denosumab, 1 mg	1,860	18	$0
99214	Established patient office or other outpatient visit, 30-39 minutes	343	210	$0
36415	Insertion of needle into vein for collection of blood sample	241	155	$0
99213	Established patient office or other outpatient visit, 20-29 minutes	204	135	$0
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	198	198	$0

View full utilization report →

Insurance plans in this area (ZIP 46052)

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Provider's Procedures

EMMA JOY NORDSTROM (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
FAMILY MEDICINE	IN	90670	Pneumococcal vaccine for injection into muscle	48	48

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4082523170View full group profile

Name	Specialty	State
DOUGLAS BLACKLIDGE (DPM)	P O D I A T R Y	IN
HERSCHELL JR. SERVIES (M.D.)	-	IN
MICHAEL W. CHAPMAN (M.D.)	-	IN
DR. NIZAR OLABI (DO)	O B S T E T R I C S/ G Y N E C O L O G Y	IN
MRS. STACI JEANNE SIDES (NP)	Nurse Practitioner	IN
DR. BRANDON J HORN (DO)	Orthopedic Surgery	IN
DR. KEITH T HUFF (MD)	-	IN
DR. ASHLEIGH THARP (DO)	Family Practice	IN
MR. DOUGLAS JOHN LADIKA (PA-C)	-	IN
MR. ANDREW SOLLARS (PT)	Physical Therapist In Private Practice	KY