Unknown Individual – Family Nurse Practitioner, NPI 1033603113

Family Nurse Practitioner

Unknown Individual is a healthcare provider. based in Indianapolis, Indiana. specializing in Family Nurse Practitioner. They hold a License No. 71008054A (IN). The NPI Number for Unknown Individual is 1033603113

Main info

Organization

Inactive

8 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1033603113

Phone

(317) 962-2929

Address

1633 N CAPITOL AVE STE 322

Deactivation Date

29 November 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

Graduation Year

2018 (8 years ago)

PAC ID

0941558282

Group Practice PAC ID

5799755864

Professional Enrollment ID

I20180802003477

Contacts

Secure Messaging

kjames1@direct.iuhealth.org

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness85

Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

322, North Capitol Avenue, Indianapolis, Marion, Indiana, 46204, United States
INDIANAPOLIS, IN 462021476
Phone: (317) 962-2929
Fax: (317) 962-2070
Type: Mailing
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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
99350	Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	82	39	$0

View full utilization report →

Insurance plans in this area (ZIP 46202)

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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: 5799755864View full group profile

Name	Specialty	State
COURTNEY BEAM (FNP-BC)	-	IN
KAMAL C WAGLE (MD)	Geriatric Medicine, Internal Medicine	NJ
GORDON A LANG (NP)	Nurse Practitioner	TX
MICHAEL A LITWILLER (MD)	-	IN
HERBERT REID MATTISON (MD)	-	IN
JOANNA E CHAMBERS (M.D.)	-	IN
VIJAYASREE PALERU (M.D.)	Cardiovascular Disease (Cardiology)	IN
BAILEY NOEL HERRON (NP)	-	IN
JAMES A SCHEIDLER (MD)	-	IN
TRACY D GUNTER (MD)	-	IN