Individual provider Active NPI

Michaela Anderson, NP-C

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1073125407
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71010347A Issued in IN
Practice address
3900 St Francis Way Ste 200
Lafayette, IN 47905-4940
Phone
(765) 775-2800
Fax
(765) 775-2837
NPI assigned
Aug 18, 2020
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28205319A IN
Family Nurse Practitioner 363LF0000X 71010347A IN Primary

Addresses

Primary practice location

3900 St Francis Way Ste 200
Lafayette, IN 47905-4940

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

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
I20201030002079 IN Practitioner - Nurse Practitioner 2860802972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

3900 St Francis Way
Suite 200
Lafayette, IN 47905-4923
Phone (765) 463-2399

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28205319AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Multi-Specialty CurrentSince Nov 1, 2020 Accepting new patients
Franciscan Physician Network CurrentSince Nov 1, 2020 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

3900 St Francis Way
Ste 200
Lafayette, IN 47905
Phone (765) 775-2800

3920 St Francis Way
Ste 209
Lafayette, IN 47905
Phone (765) 775-2830

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1073125407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 ST FRANCIS WAY STE 200",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054940",
            "telephone_number": "765-775-2800",
            "fax_number": "765-775-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICHAELA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28205319A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010347A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.