Individual provider Active NPI

Laura Wheeler, N.P.

  • Family Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1104898790
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71000844A Issued in IN
Practice address
2824 Elkhart Rd
Goshen, IN 46526-1014
Phone
(574) 295-7178
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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 71000844A IN Primary

Addresses

Primary practice location

2824 Elkhart Rd
Goshen, IN 46526-1014

Mailing address

2824 Elkhart Rd
Goshen, IN 46526-1014

Other identifiers 2

IdentifierTypeStateIssuer
200272820MedicaidIN
000000532188OtherANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laura.wheelernp.p1@direct.goshenphysicians.nextgenshare.com Health Information Exchange (HIE)

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
I20040616001114 IN Practitioner - Nurse Practitioner 9830173806 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000844AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Hospital Association Inc Current Accepting new patients
Elite Emergency Physicians Inc CurrentSince May 1, 2013 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Past Accepting new patients

Locations

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

Interoperability endpoints

  • Direct secure messaging: laura.wheeler@goshenhealthdirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1104898790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261014",
            "telephone_number": "574-295-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000844A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200272820",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000532188",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laura.wheelernp.p1@direct.goshenphysicians.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2824 Elkhart Rd",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465261014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.