Individual provider Active NPI

Natalie Ann Emmert

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1285058081
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28162258A Issued in IN
Practice address
211 N Eddy St
South Bend, IN 46617-2808
Phone
(574) 204-7200
NPI assigned
Feb 13, 2014
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28162258A IN Primary

Addresses

Primary practice location

211 N Eddy St
South Bend, IN 46617-2808

Mailing address

1802 Day Rd
Mishawaka, IN 46545-4329
Phone (574) 204-7200

Other practice location 1

1802 Day Rd
Mishawaka, IN 46545-4329
Phone (574) 204-7200

Other practice location 2

2102 E Inwood Rd
South Bend, IN 46614-2443
Phone (574) 204-7200

Other identifiers 1

IdentifierTypeStateIssuer
201250030MedicaidIN

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
I20140925000132 IN Practitioner - Nurse Practitioner 5991925992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28162258AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC CurrentSince Sep 15, 2014 Accepting new patients
The South Bend Clinic, LLC CurrentSince Sep 15, 2014 Accepting new patients

Locations

1802 Day Rd
Mishawaka, IN 46545
Phone (574) 204-7200

2102 E Inwood Rd
South Bend, IN 46614
Phone (574) 299-2400

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

Interoperability endpoints

  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1285058081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 DAY RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465454329",
            "telephone_number": "574-204-7200",
            "fax_number": "574-252-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-204-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 Day Rd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465454329",
            "country_code": "US",
            "telephone_number": "574-204-7200",
            "fax_number": "574-252-0633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2102 E Inwood Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142443",
            "country_code": "US",
            "telephone_number": "574-204-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMERT",
        "first_name": "NATALIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28162258A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201250030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.