Individual provider Active NPI

Laura Droege, NP

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1174174635
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009469A Issued in IN
Practice address
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone
(574) 335-5000
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201805230RN OR
Family Nurse Practitioner 363LF0000X 71009469A IN Primary

Addresses

Primary practice location

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

Mailing address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000

Other names 1

  • Laura Goodale Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210504002196 FL Practitioner - Nurse Practitioner 9335470517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Cardiologists of Gainesville, PAGroup PAC ID 8820077241, 36 clinicians

Practice addresses (Care Compare)

4645 NW 8TH Ave
Suite 20
Gainesville, FL 32605-4688
Phone (352) 375-1212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201805230RNORMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Cardiologists of Gainesville, PA CurrentSince Jun 1, 2021 Accepting new patients

Locations

4645 NW 8th Ave
Gainesville, FL 32605
Phone (352) 264-2500

4645 NW 8th Ave
Ste 20
Gainesville, FL 32605
Phone (352) 375-1212

1151 NW 64th Ter
Gainesville, FL 32605
Phone (352) 331-8570

3239 NW York Dr
Lake City, FL 32055
Phone (352) 375-1212

Organizations & group practices 1

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": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1174174635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROEGE",
        "first_name": "LAURA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201805230RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009469A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "GOODALE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.