Individual provider Active NPI

Lauren Reisberg, NP-C

  • Family Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1124578653
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006622B Issued in IN
Practice address
1001 Sturdy Rd
Valparaiso, IN 46383-4126
Phone
(219) 462-7173
Fax
(219) 462-7504
NPI assigned
Oct 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 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 71006622B IN Primary

Addresses

Primary practice location

1001 Sturdy Rd
Valparaiso, IN 46383-4126

Mailing address

2009 McCord Rd
Valparaiso, IN 46383-3815

Other practice location 1

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

Other identifiers 1

IdentifierTypeStateIssuer
201401690MedicaidIN

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
I20161103001448 IN Practitioner - Nurse Practitioner 3476831934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

1001 Sturdy Rd
Valparaiso, IN 46383-4126
Phone 21946271732226

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006622BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc CurrentSince Oct 7, 2016 Accepting new patients
Healthlinc, Inc. CurrentSince Oct 7, 2016 Accepting new patients

Locations

2323 Broadway St
East Chicago, IN 46312

200 Alfred St
Michigan City, IN 46360
Phone (219) 413-5100

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

621 Memorial Dr
South Bend, IN 46601
Phone (574) 236-1888

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

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

Interoperability endpoints

  • Direct secure messaging: lauren.reisberg@healthlinc.directbygreenway.com

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, 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": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1124578653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 MCCORD RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 STURDY RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463834126",
            "telephone_number": "219-462-7173",
            "fax_number": "219-462-7504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Alfred St",
            "address_purpose": "LOCATION",
            "city": "Michigan City",
            "state": "IN",
            "postal_code": "46360",
            "country_code": "US",
            "telephone_number": "219-872-6200",
            "fax_number": "219-879-2915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISBERG",
        "first_name": "LAUREN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006622B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201401690",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.