Individual provider Active NPI

Karen Fagan, APN

  • Family Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1114463502
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015643 Issued in IL
Practice address
200 Alfred St
Michigan City, IN 46360
Phone
(815) 773-7827
NPI assigned
Jan 10, 2017
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 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 209015643 IL Primary

Addresses

Primary practice location

200 Alfred St
Michigan City, IN 46360

Mailing address

710 Franklin St Ste 200
Michigan City, IN 46360-3564
Phone (219) 872-6200

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
I20210806000257 IN Practitioner - Nurse Practitioner 5698042489 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthlinc IncGroup PAC ID 7618929373, 83 clinicians
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

1001 Sturdy Rd
Valparaiso, IN 46383-4126
Phone 21946271732226

200 Alfred St
Michigan City, IN 46360-3563
Phone (219) 872-6200

425 Sand Creek Dr
Chesterton, IN 46304-1589

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Villagemd Indiana, PC CurrentSince Aug 1, 2021 Accepting new patients
Healthlinc, Inc. Current Accepting new patients
Healthlinc, Inc CurrentSince Sep 1, 2023 Accepting new patients
Community Care Health Network LLC CurrentSince Oct 1, 2022 Accepting new patients
Healthlinc, Inc Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

125 S Clark St
Ste 900
Chicago, IL 60603
Phone (346) 980-2701

1313 W Chicago Ave
East Chicago, IN 46312
Phone (219) 397-1196

3815 River Crossing Pkwy
Ste 100
Indianapolis, IN 46240
Phone (317) 566-2035

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

400 Teegarden St
Laporte, IN 46350
Phone (219) 326-0043

6097 Broadway
Merrillville, IN 46410
Phone (219) 758-5152

200 Alfred St
Michigan City, IN 46360
Phone (219) 224-2626

710 Franklin St
Ste 200
Michigan City, IN 46360
Phone (219) 872-6200

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

1960 Northside Blvd
South Bend, IN 46615
Phone (574) 231-7228

621 Memorial Dr
Ste 402
South Bend, IN 46601
Phone (574) 232-4800

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

Organizations & group practices 7

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 2

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": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1114463502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 FRANKLIN ST STE 200",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603564",
            "telephone_number": "219-872-6200",
            "fax_number": "219-879-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ALFRED ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "46360",
            "telephone_number": "815-773-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "KAREN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.