Individual provider Active NPI

Rebecca L Allen-Legault, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Granger, IN
National Provider Identifier
1104892371
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71000950A Issued in IN
Practice address
6910 N Main St Unit 52
Granger, IN 46530-8412
Phone
(574) 231-6766
Fax
(833) 249-2411
NPI assigned
Feb 27, 2006
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71000950A IN Primary

Addresses

Primary practice location

6910 N Main St Unit 52
Granger, IN 46530-8412

Mailing address

50755 Timothy Rd
New Carlisle, IN 46552-9636
Phone (574) 210-1850

Other names 1

  • Rebecca L Allen Former name

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
I20040616000044 IN Practitioner - Nurse Practitioner 0648254888 Practice locations: New Carlisle, IN; Granger, IN

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

50755 Timothy Rd
New Carlisle, IN 46552-9636
Phone (574) 272-0100

Merit-based Incentive Payment System (MIPS)

Final score
46.01 of 100Reported as group
Quality
31.67
Improvement activities
0
Cost
77.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000950AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Behavior Management Specialists, Inc. CurrentSince Apr 14, 2024 Accepting new patients
Saint Joseph Community Hospital of Mishawaka Past Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. Past Accepting new patients

Locations

6910 N Main St
Unit 52
Granger, IN 46530
Phone (574) 231-6766

1950 Ridgedale Rd
South Bend, IN 46614
Phone (571) 291-6722

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.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1104892371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50755 TIMOTHY RD",
            "city": "NEW CARLISLE",
            "state": "IN",
            "postal_code": "465529636",
            "telephone_number": "574-210-1850",
            "fax_number": "574-210-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 N MAIN ST UNIT 52",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308412",
            "telephone_number": "574-231-6766",
            "fax_number": "833-249-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN-LEGAULT",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71000950A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "ALLEN",
            "middle_name": "L",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.