Individual provider Active NPI

Alissa Anglemyer, FNP-C

  • Family Nurse Practitioner
  • Kendallville, IN
National Provider Identifier
1073359329
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06241725 Issued in IN
Practice address
610 N Sawyer Rd
Kendallville, IN 46755-2566
Phone
(918) 931-0861
NPI assigned
Jul 6, 2024
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06241725 IN Primary

Addresses

Primary practice location

610 N Sawyer Rd
Kendallville, IN 46755-2566

Mailing address

28 EMS T15B LN
Leesburg, IN 46538-9563

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
I20241003001754 IN Practitioner - Nurse Practitioner 9638600497 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Internal Medicine Associates, PCGroup PAC ID 7113830688, 52 clinicians
Hospital Care Group PCGroup PAC ID 7416107487, 29 clinicians

Practice addresses (Care Compare)

2500 N Detroit St
Lagrange, IN 46761-1158
Phone (260) 463-2133

2520 E Dupont Rd
Fort Wayne, IN 46825-1675
Phone (260) 344-4035

7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 344-4035

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06241725INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Internal Medicine Associates, PC CurrentSince Oct 1, 2024 Accepting new patients
Northeast Internal Medicine Associates, PC Past Accepting new patients

Locations

610 N Sawyer Rd
Kendallville, IN 46755
Phone (260) 347-5592

2500 N Detroit St
Lagrange, IN 46761
Phone (260) 463-2133

Organizations & group practices 3

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 6

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": "1720224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1073359329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 EMS T15B LN",
            "city": "LEESBURG",
            "state": "IN",
            "postal_code": "465389563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N SAWYER RD",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467552566",
            "telephone_number": "918-931-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGLEMYER",
        "first_name": "ALISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-06",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F06241725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

Verify at the official NPI Registry.