Individual provider Active NPI

Caitlin Vlaeminck

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1083919161
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003581A Issued in IN
Practice address
100 Navarre PL Ste 4440
South Bend, IN 46601-1171
Phone
(574) 647-5300
Fax
(574) 647-5305
NPI assigned
Jan 20, 2011
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 71003581A IN Primary

Addresses

Primary practice location

100 Navarre PL Ste 4440
South Bend, IN 46601-1171

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

1815 E Ireland Rd
South Bend, IN 46614-2845
Phone (746) 471-7005

Other identifiers 1

IdentifierTypeStateIssuer
300049371MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cvlaeminck@mybeacon.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 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

Enrollment IDStateProvider typePAC IDDetails
I20110316000566 IN Practitioner - Nurse Practitioner 6709068422 Reassigns benefits to 2 organizations
I20180115000742 MI Practitioner - Nurse Practitioner 6709068422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

100 Navarre PL
4440 Beacon Bone and Joint Specialists
South Bend, IN 46601-1171
Phone (574) 647-5300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003581AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. Family CurrentSince Jun 21, 2021 Accepting new patients
Michiana Spine, Sports & Occupational Rehab, PC CurrentSince Nov 10, 2016 Accepting new patients
Beacon Medical Group Inc CurrentSince Jun 21, 2021 Accepting new patients
Michiana Spine, Sports & Occupational Rehab, PC CurrentSince Nov 10, 2016 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

51050 Bittersweet Rd
Ste C
Granger, IN 46530
Phone (574) 252-4150

3740 Edison Lakes Pkwy
Mishawaka, IN 46545
Phone (574) 252-4150

100 Navarre Pl
Ste 4440
South Bend, IN 46601
Phone (574) 647-4540

1815 E Ireland Rd
South Bend, IN 46614
Phone (574) 647-1700

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

621 Memorial Dr
Ste 302
South Bend, IN 46601
Phone (574) 236-1888

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

2946 Division St
Saint Joseph, MI 49085
Phone (213) 232-5630

Interoperability endpoints

  • Direct secure messaging: cvlaeminck@mybeacon.cernerdirect.com

Organizations & group practices 6

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 8

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": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1083919161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL STE 4440",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011171",
            "telephone_number": "574-647-5300",
            "fax_number": "574-647-5305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 E Ireland Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142845",
            "country_code": "US",
            "telephone_number": "746-471-7005",
            "fax_number": "574-647-7572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VLAEMINCK",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-20",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003581A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300049371",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cvlaeminck@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Navarre Pl Ste 4440",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.