Rebecca Nicole Brueck, MSN RN PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71017278A Issued in IN

Practice address

836 N Detroit St
Lagrange, IN 46761-1112

Phone

(260) 499-3019

Fax

(260) 499-3022

NPI assigned

Jul 27, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illume Wellness GroupGroup PAC ID 4880088210, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rbrueck31496@lakeland.midirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Illume Wellness Group

  • Professional Counselor
  • Sturgis, MI
  • NPI 1942978572

  MI

  Medicare reassignment Care Compare group NPD
• Bowen Health Inc

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810

  IN

  Medicare reassignment NPD
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Cassopolis, MI
  • NPI 1982677548

  MI

  Medicare reassignment NPD
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1881492338
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1003120510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 E JEFFERSON ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803880",
            "telephone_number": "574-267-7169",
            "fax_number": "574-269-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 N DETROIT ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467611112",
            "telephone_number": "260-499-3019",
            "fax_number": "260-499-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUECK",
        "first_name": "REBECCA",
        "middle_name": "NICOLE",
        "credential": "MSN RN PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704277738",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71017278A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Booth Medical Center PC
• Lynn R Bowen, DDS
• Robin D Brauchla, NP
• Elizabeth R. Burkhart, NP
• Louis Bustos
• Megan Marie Buuck, FNP
• Katrina M Carlson
• Decoma Nicole Cavender, FNP-BC

• All providers in Lagrange, IN
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.