Individual provider Active NPI

Angela M Vanderberg, FNP-BC, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Merrillville, IN
National Provider Identifier
1093019994
Registry record updated Sep 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71003513 Issued in IN
Practice address
2646 W Lincoln Hwy Ste a
Merrillville, IN 46410-5235
Phone
(219) 444-7946
Fax
(219) 444-4398
NPI assigned
Jan 6, 2011
Last updated
Sep 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2026

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 71003513 IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71003513 IN Primary

Addresses

Primary practice location

2646 W Lincoln Hwy Ste a
Merrillville, IN 46410-5235

Mailing address

3217 W 121St Ave
Crown Point, IN 46307-8745
Phone (219) 444-7946

Other practice location 1

7891 Broadway Ste F
Merrillville, IN 46410-5556
Phone (219) 444-7946

Other identifiers 1

IdentifierTypeStateIssuer
IN2007010OtherINMEDICARE PTAN

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
I20110218000567 IN Practitioner - Nurse Practitioner 0547441917 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003513INMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Wellness Medical LLC Family CurrentSince Dec 7, 2025 Accepting new patients

Locations

2646 W Lincoln Hwy
Ste A
Merrillville, IN 46410
Phone (219) 444-7946

7805 Taft St
Ste E
Merrillville, IN 46410
Phone (219) 230-4667

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.

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789862400000",
    "number": "1093019994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 W 121ST AVE",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078745",
            "telephone_number": "219-444-7946",
            "fax_number": "219-444-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2646 W LINCOLN HWY STE A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105235",
            "telephone_number": "219-444-7946",
            "fax_number": "219-444-4398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7891 Broadway Ste F",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464105556",
            "country_code": "US",
            "telephone_number": "219-444-7946",
            "fax_number": "219-444-4398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERBERG",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "FNP-BC, PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-06",
        "last_updated": "2026-09-20",
        "certification_date": "2026-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003513",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71003513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IN2007010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.