Individual provider Active NPI

Flora Mashibe, NP

  • Nurse Practitioner
  • Brownsburg, IN
National Provider Identifier
1124406590
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG0814037 Issued in IN
Practice address
7398 Windridge Way
Brownsburg, IN 46112-8985
Phone
(317) 858-7207
NPI assigned
May 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG0814037 IN Primary

Addresses

Primary practice location

7398 Windridge Way
Brownsburg, IN 46112-8985

Mailing address

7398 Windridge Way
Brownsburg, IN 46112-8985
Phone (317) 858-7207

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
I20150908002488 IN Practitioner - Nurse Practitioner 2769798693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

611 E Douglas Rd
Suite 203
Mishawaka, IN 46545-1467
Phone (574) 335-6830

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG0814037INMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center, Inc. Nurse Practitioner CurrentSince Nov 25, 2024 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Nurse Practitioner CurrentSince Nov 25, 2024 Accepting new patients

Locations

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

611 E Douglas Rd
Ste 203
Mishawaka, IN 46545
Phone (574) 335-6640

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

Interoperability endpoints

  • Direct secure messaging: fmashibe3878933@direct.trinity-health.org

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 and National Provider Directory roles.

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1124406590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7398 WINDRIDGE WAY",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461128985",
            "telephone_number": "317-858-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7398 WINDRIDGE WAY",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461128985",
            "telephone_number": "317-858-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHIBE",
        "first_name": "FLORA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "AG0814037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

Verify at the official NPI Registry.