JEAN C SELF (NPI# 1053764035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053764035 |
| Entity Type | Individual |
| Full Name | JEAN C SELF |
| Other Name | JEAN C BILGER |
| Practice Address |
3400 Lafayette Rd Suite 200 Indianapolis IN 46222-1146 |
| Practice Telephone | 3172917422 |
| Practice Fax Number | 3172917433 |
| Mailing Telephone | 3172917422 |
| Mailing Fax Number | 3172917433 |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
71006382A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3400 LAFAYETTE RD SUITE 200 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46222-1146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538167036 | Shalom Health Care Center, Inc. | Clinic/Center | 3400 Lafayette Rd, Sutie 200, Indianapolis, IN 46222-1146 | 2005-07-08 |
| 1982242327 | Shalom Health Care Center, Inc. | Clinic/Center | 3400 Lafayette Rd, Mobile Unit, Indianapolis, IN 46222-1146 | 2019-12-17 |
| 1215581376 | Maddison Barley | Nurse Practitioner | 3400 Lafayette Rd, Indianapolis, IN 46222-1146 | 2019-07-27 |
| 1588112544 | Christa Goebes | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Indianapolis, IN 46222-1146 | 2016-09-19 |
| 1497107635 | Erin E Boschert | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Indianapolis, IN 46222 | 2016-07-12 |
| 1083081590 | Kylie Marie Ross | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Indianapolis, IN 46222-1146 | 2015-09-01 |
| 1013384361 | Jessica Tennille Duerksen | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Indianapolis, IN 46222-1146 | 2015-08-21 |
| 1447669213 | Rachael E Drye | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Indianapolis, IN 46222-1146 | 2014-08-06 |
| 1407285380 | Jacquelyn Ann Krueger | Nurse Practitioner | 3400 Lafayette Rd, Indianapolis, IN 46222-1146 | 2013-11-01 |
| 1609176197 | Megan Marie Carlson | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Indianapolis, IN 46222-1146 | 2010-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871194472 | Megan Mccullough | Pharmacist | 10617 East Washington Street, Pharmacy At Walmart, Indianapolis, IN 46222 | 2020-11-02 |
| 1215401450 | Resilient Services | Counselor | 3519 W Michigan Street, Indianapolis, IN 46222 | 2019-01-21 |
| 1376925487 | Ossama Elbarawy | Dentist | 2410 W. 17th St, Indianapolis, IN 46222 | 2015-06-25 |
| 1780025163 | Suzy Q Service Cororation | Chore Provider | 2401 N Tibbs Ave, Indianapolis, IN 46222 | 2013-07-12 |
| 1952607939 | Monica Lee Mcmullen | Dietitian, Registered | 2732 West Michigan St., Westside Health Center, Indianapolis, IN 46222 | 2011-02-08 |
| 1306082318 | Jose Fanor Melendez | Psychiatry & Neurology | 3422 N. Taft Av, Indianapolis, IN 46222 | 2008-12-22 |
| 1861693277 | David Hazra | Preventive Medicine | 340 S. White River Parkway, Indianapolis, IN 46222 | 2007-05-31 |
| 1528191467 | Rem Indiana | Intermediate Care Facility, Mentally Retarded | 3025 Green Hills Lane, Indianapolis, IN 46222 | 2007-03-13 |
| 1366589467 | Indianapolis Osteopathic Hospital Inc. | Podiatrist | 3520 Guion Rd Suite 204, Indianapolis, IN 46222 | 2007-01-30 |
| 1508919077 | Ronald L. Gemma | Family Medicine | 3750 Guion Rd., Ste. 185, Indianapolis, IN 46222 | 2007-01-19 |
| Find all providers in zip 46222 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822844 | Kelsey M Knight | Nurse Practitioner | 705 Riley Hospital Dr Ste 1601, Indianapolis, IN 46202-5109 | 2020-08-21 |
| 1427594696 | Alecia A Woody | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Shalom Health Care Center Inc, Indianapolis, IN 46222-1146 | 2017-01-12 |
| 1710230388 | Nicole Lois Mohr-eslinger | Nurse Practitioner | 8010 E 75th St, Indianapolis, IN 46256-2003 | 2012-10-19 |
| 1952650673 | Juliann Kay Kiefer | Nurse Practitioner | 705 Riley Hospital Dr # 4340, Indianapolis, IN 46202-5109 | 2012-09-10 |
| 1184911588 | Paul G Dengler | Nurse Practitioner | 2451 N Keystone Ave, Indianapolis, IN 46218-3503 | 2011-07-06 |
| 1710296629 | Katherine Magoon | Nurse Practitioner | 2001 W 86th St Fl 3, Indianapolis, IN 46260-1902 | 2010-09-27 |
| 1669701629 | Indianapolis Neurosurgical Group | Nurse Practitioner | 702 Riley Hospital Dr, Suite 1134, Indianapolis, IN 46202-5139 | 2009-12-21 |
| 1508191750 | Allison Rose Hammer | Nurse Practitioner | 575 Riley Hospital Dr Ste 2240, Indianapolis, IN 46202-5272 | 2009-10-06 |
| 1225298227 | Sharon Kaye Tormoehlen | Nurse Practitioner | 702 Barnhill Dr Rm 4340, Indianapolis, IN 46202-5128 | 2008-06-12 |
| 1639351745 | Elissa A. Jones-hua | Nurse Practitioner | 2802 Lafayette Rd, Suite 13, Indianapolis, IN 46222-2157 | 2007-11-30 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46222 |
Please comment or provide details below to improve the information on JEAN C SELF.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.