CARLA S PAYNE RN FNP NPI 1063771962

NPI Information

NPI: 1063771962
Provider Name: CARLA S PAYNE, RN, FNP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
360 S MADISON AVE
SUITE 100
GREENWOOD, IN
ZIP 46142
Phone: (317) 881-8248
Get Directions

Carla S Payne, RN, FNP is a primary care nurse practitioner in Greenwood, IN with 12 years of experience. Carla S Payne, RN, FNP NPI is 1063771962. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

360 S MADISON AVE
SUITE 100
GREENWOOD, IN
ZIP 46142-117
Phone: (317) 881-8248
Fax: (317) 885-8216

The NPI 1063771962 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/11/2012 and was last updated on 7/2/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		28160871A	INDIANA	No
2	363LF0000X	Nurse Practitioner	Family	71004088A	INDIANA	No
3	363LP2300X	Nurse Practitioner	Primary Care	71004088A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201085440	MEDICAID	INDIANA
2	000000791892	OTHER	INDIANA	ANTHEM
3	9360882	OTHER	INDIANA	AETNA
4	000000779844	OTHER	INDIANA	ANTHEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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