Basic Information
| Provider Information | |||||||||
| NPI: | 1629054044 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMITT | ||||||||
| FirstName: | JOHNALLEN | ||||||||
| MiddleName: | F. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 PLAZA DR | ||||||||
| Address2: | SUITE H | ||||||||
| City: | COLUMBUS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 472012916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123484000 | ||||||||
| FaxNumber: | 8123760678 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 17TH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 472015351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123484000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2005 | ||||||||
| LastUpdateDate: | 04/25/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 71002032A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 200920710 | 05 | IN | MEDICAID | 000000983416 | 01 | IN | ANTHEM PIN | OTHER |