Individual provider Active NPI

Mandy Vires, FNP

  • Nurse Practitioner
  • Kokomo, IN
National Provider Identifier
1023707171
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28193744A Issued in IN
Practice address
429 W Lincoln Rd
Kokomo, IN 46902-3508
Phone
(317) 654-3487
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28193744A IN Primary

Addresses

Primary practice location

429 W Lincoln Rd
Kokomo, IN 46902-3508

Mailing address

13313 Rhineland Pass
Fishers, IN 46037-7717
Phone (317) 654-3487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230714002032 IN Practitioner - Nurse Practitioner 6709246366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Clinical PartnersGroup PAC ID 6608302872, 2 clinicians
Rpinmd LLCGroup PAC ID 4183014616, 13 clinicians

Practice addresses (Care Compare)

3500 Depauw Blvd
Indianapolis, IN 46268-1170
Phone (317) 443-8172

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

Hospital & facility affiliations

  • Best Choice Home Care Home health agency, Indianapolis, IN, CCN 157560
  • Elite Home Rehab and Healthcare Corp Home health agency, Carmel, IN, CCN 157692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28193744AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Clinical Partners CurrentSince Oct 24, 2024 Accepting new patients
Rpinmd LLC CurrentSince Feb 15, 2024 Accepting new patients

Locations

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

3500 Depauw Blvd
Indianapolis, IN 46268
Phone (317) 443-8172

3500 Depauw Blvd
Ste 10801
Indianapolis, IN 46268
Phone (317) 531-1783

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1023707171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13313 RHINELAND PASS",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377717",
            "telephone_number": "317-654-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023508",
            "telephone_number": "317-654-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRES",
        "first_name": "MANDY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28193744A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.