Individual provider Active NPI

Laura Roberts, FNP

  • Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1033070867
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71017256A Issued in IN
Practice address
413 W McKinley Ave
Mishawaka, IN 46545-5599
Phone
(574) 282-3230
NPI assigned
Nov 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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 71017256A IN Primary

Addresses

Primary practice location

413 W McKinley Ave
Mishawaka, IN 46545-5599

Mailing address

529 Main St
Rochester, IN 46975-1317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 13, 2026 through Jul 13, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
71017256AINMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1033070867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 MAIN ST",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469751317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W MCKINLEY AVE",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465455599",
            "telephone_number": "574-282-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LAURA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71017256A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.