Healthcare Provider Details

I. General information

NPI: 1093006496
Provider Name (Legal Business Name): JENI ANNE SHULL CLAYTON M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENI ANNE SHULL M.D., M.P.H.

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19800 EAST ST STE 120
WESTFIELD IN
46074-3833
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 463-622-9850
  • Fax: 463-622-9851
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number01076037A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01076037A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: