Individual provider Active NPI

Corinne Michelle Djuric, NP

  • Family Nurse Practitioner
  • Wheatfield, IN
National Provider Identifier
1164780276
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003937A Issued in IN
Practice address
165 E Robbins St
Wheatfield, IN 46392-6006
Phone
(219) 956-3004
Fax
(219) 956-3006
NPI assigned
Apr 26, 2012
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71003937A IN Primary
Family Nurse Practitioner 363LF0000X 28158749A IN

Addresses

Primary practice location

165 E Robbins St
Wheatfield, IN 46392-6006

Mailing address

165 E Robbins St
Wheatfield, IN 46392-6006
Phone (219) 956-3004

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
I20120620000242 IN Practitioner - Nurse Practitioner 3971767153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

801 Macarthur Blvd
Suite 401
Munster, IN 46321-2919
Phone (219) 440-5290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28158749AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Apr 1, 2022 Accepting new patients
Munster Medical Research Foundation Inc Current Accepting new patients
Cardiospecialists Group LTD PastSince May 11, 2013 Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

503 Otis Bowen Dr
Munster, IN 46321
Phone (219) 934-0590

801 MacArthur Blvd
Ste 401
Munster, IN 46321
Phone (219) 836-2860

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

Organizations & group practices 3

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 4

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1164780276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 E ROBBINS ST",
            "city": "WHEATFIELD",
            "state": "IN",
            "postal_code": "463926006",
            "telephone_number": "219-956-3004",
            "fax_number": "219-956-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E ROBBINS ST",
            "city": "WHEATFIELD",
            "state": "IN",
            "postal_code": "463926006",
            "telephone_number": "219-956-3004",
            "fax_number": "219-956-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJURIC",
        "first_name": "CORINNE",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003937A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28158749A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheatfield, IN

Sources for this page

Verify at the official NPI Registry.