Individual provider Active NPI

Chimi Nusbaum, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1265809321
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71005652A Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 415-7921
Fax
(317) 415-7922
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71005652A IN Primary

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

707 Cedar St Ste 405
South Bend, IN 46617-2059
Phone (574) 335-8707

Other practice location 1

11115 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 672-6443

Other practice location 2

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

Other practice location 3

1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone (317) 355-1411

Other practice location 4

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

Other identifiers 3

IdentifierTypeStateIssuer
P02078333OtherINMEDICARE RAIDROAD
201316100MedicaidIN
000000959681OtherINBCBS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cnusbaum313545@eCommunityDirect.com Community Physicians of Indiana Inc
Direct Messaging Address chimi.nusbaum@lutheranhealthnetwork.cernerdirect.com

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
I20150915001456 IN Practitioner - Nurse Practitioner 1153638762 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71005652AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Nurse Practitioner Current Accepting new patients
Parkview Health System, Inc. Nurse Practitioner CurrentSince Mar 25, 2022 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
St Vincent Pediatric Subspecialties Nurse Practitioner CurrentSince Jan 1, 2026 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Neonatal CurrentSince Oct 1, 2015 Accepting new patients
Lutheran Medical Group LLC CurrentSince May 22, 2019 Accepting new patients
Lutheran Medical Group LLC Nurse Practitioner CurrentSince May 22, 2019 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Oct 1, 2015 Accepting new patients
St Vincent Pediatric Subspecialties Nurse Practitioner CurrentSince Jan 1, 2026 Accepting new patients

Locations

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

11115 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-5400

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

Interoperability endpoints

  • Direct secure messaging: cnusbaum1147680@direct.trinity-health.org
  • Direct secure messaging: cnusbaum313545@ecommunitydirect.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1265809321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059",
            "telephone_number": "574-335-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-415-7921",
            "fax_number": "317-415-7922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11115 Parkview Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451701",
            "country_code": "US",
            "telephone_number": "260-672-6443",
            "fax_number": "260-672-6559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7950 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044140",
            "country_code": "US",
            "telephone_number": "260-435-7001",
            "fax_number": "260-435-7632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 N Ritter Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462193027",
            "country_code": "US",
            "telephone_number": "317-355-1411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5215 Holy Cross Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "46545",
            "country_code": "US",
            "telephone_number": "574-335-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUSBAUM",
        "first_name": "CHIMI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005652A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIDROAD",
            "identifier": "P02078333",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201316100",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000959681",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnusbaum313545@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7240 Shadeland Station",
            "address_2": "Suite 300",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462563944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chimi.nusbaum@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7950 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.