Organization Active NPI

Nurse Practitioner Services of Michiana

Doing business as NPS Wellness

  • Primary Care Clinic/Center
  • Elkhart, IN
National Provider Identifier
1225605207
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NURSE PRACTITIONER SERVICES OF MICHIANA
Doing business as
NPS Wellness
Practice address
5230 Beck Dr Ste 3
Elkhart, IN 46516-9059
Phone
(574) 622-1522
Fax
(574) 699-1588
NPI assigned
Jun 8, 2021
Last updated
Oct 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Authorized official

Name
Kertes Stephanie, NP
Title
Owner
Phone
(574) 274-3925

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

5230 Beck Dr Ste 3
Elkhart, IN 46516-9059

Mailing address

5230 Beck Dr Ste 3
Elkhart, IN 46516-9059
Phone (574) 622-1522

Other identifiers 1

IdentifierTypeStateIssuer
201317770MedicaidIN

Other names 3

  • NPS Wellness Doing business as
  • Neighborhood Nurse Practitioner Services Former legal business name
  • Nurse Practitioner Services of Michiana Former legal business name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2229131Nurse Practitioner Services of Michiana5230 Beck Drive, Suite 3, Elkhart, IN 46516Certificate of waiverJul 6, 2027

National Provider Directory

National Provider Directory

Locations

2004 Mishawaka St
Elkhart, IN 46514
Phone (574) 622-1522

2901 E Bristol St
Ste B
Elkhart, IN 46514

5230 Beck Dr
Ste 3
Elkhart, IN 46516
Phone (574) 218-0572

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24149/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1225605207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 BECK DR STE 3",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169059",
            "telephone_number": "574-622-1522",
            "fax_number": "833-310-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 BECK DR STE 3",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169059",
            "telephone_number": "574-622-1522",
            "fax_number": "574-699-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE PRACTITIONER SERVICES OF MICHIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "STEPHANIE",
        "authorized_official_first_name": "KERTES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-274-3925",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201317770",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NPS Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neighborhood Nurse Practitioner Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Nurse Practitioner Services of Michiana",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.