Individual provider Active NPI

Victoria Tiemens, NP

  • Family Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1255816567
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008467A Issued in IN
Practice address
4111 Franklin St
Michigan City, IN 46360-7803
Phone
(219) 873-2919
Fax
(219) 873-2909
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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 28116088A IN
Family Nurse Practitioner 363LF0000X 71008467A IN Primary

Addresses

Primary practice location

4111 Franklin St
Michigan City, IN 46360-7803

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vtiemens755716@Direct.FranciscanAlliance.org Direct

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
I20181210001165 IN Practitioner - Nurse Practitioner 9133463748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

4111 Franklin St
Michigan City, IN 46360-7803
Phone (219) 873-2919

Hospital & facility affiliations

  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28116088AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Feb 1, 2022 Accepting new patients
Cep America LLC Current Accepting new patients
Cep America LLC CurrentSince Feb 1, 2022 Accepting new patients
Franciscan Physician Network Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

101 W 61st Ave
Hobart, IN 46342
Phone (219) 945-4965

4111 Franklin St
Michigan City, IN 46360
Phone (219) 873-2919

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

7905 Calumet Ave
Munster, IN 46321
Phone (219) 836-5800

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

2307 Laporte Ave
Ste 8
Valparaiso, IN 46383
Phone (219) 464-7073

Organizations & group practices 4

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": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1255816567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607803",
            "telephone_number": "219-873-2919",
            "fax_number": "219-873-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEMENS",
        "first_name": "VICTORIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28116088A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008467A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vtiemens755716@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4111 Franklin St",
            "city": "Michigan City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463607803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.