Mandy Jean Boeckman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71007881A Issued in IN

Practice address

2796 W 500 S
Portland, IN 47371-7308

Phone

(260) 729-3523

Fax

(812) 220-4280

NPI assigned

Mar 7, 2018

Last updated

Apr 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Meridian Health Services Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muncie, IN
  • NPI 1992755490
  Medicare reassignment NPD
• Meridian Health Services Corp.

  • Federally Qualified Health Center (FQHC)
  • Montpelier, IN
  • NPI 1417838574
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1124520069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2796 W 500 S",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473717308",
            "telephone_number": "260-729-3523",
            "fax_number": "812-220-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2796 W 500 S",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473717308",
            "telephone_number": "260-729-3523",
            "fax_number": "812-220-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOECKMAN",
        "first_name": "MANDY",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007881A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas M. Banta, D.D.S.
• Jeffrey William Barr, MD
• Courtney Bible, PT
• Sophia R Binkley-Timmerman, LCAC, LMHC
• Tricia Blakely, LCSW
• Rita Ann Bollenbacher, LAT, ATC
• Elizabeth Ann Bolton
• Stephen Boyle, M.D.
• Taylor Brackman, DC
• David M Brown, DO

• Family Nurse Practitioner in Portland, IN
• Providers in Portland, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.