Amy Van de Wielle

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71012888A Issued in IN

Practice address

303 S Nappanee St
Elkhart, IN 46514-2066

Phone

(574) 296-3200

NPI assigned

Jul 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Indiana LLCGroup PAC ID 2365341674, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.van.de.wielle.1@31626.direct.athenahealth.com

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.

• Privia Medical Group Indiana, LLC

  • Multi-Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1013912286
  Medicare reassignment Care Compare group NPD
• Privia Medical Group Indiana, LLC

  • Family Nurse Practitioner
  • Wakarusa, IN
  • NPI 1568147809
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  Care Compare affiliation

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1144953902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142066",
            "telephone_number": "574-296-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Memorial Dr Ste 511",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011075",
            "country_code": "US",
            "telephone_number": "574-544-5580",
            "fax_number": "574-544-5579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 High Rd",
            "address_purpose": "LOCATION",
            "city": "Bremen",
            "state": "IN",
            "postal_code": "465061093",
            "country_code": "US",
            "telephone_number": "574-309-9967",
            "fax_number": "574-309-9968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DE WIELLE",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012888A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300069958",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Mary Urbanski
• Urology Associates of Elkhart,Inc
• Connor Timothy Utley, DC
• Utopian Society Home Care LLC
• Angela Valoy Medina
• Stacey Van Eck, M.ED., ED.S.
• Debra Vance, LMHC
• Karli Vance
• Amanda Vandergriff
• John H. Vandergrift, M.D.

• Family Nurse Practitioner in Elkhart, IN
• Providers in Elkhart, 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 Aug 11, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.