Individual provider Active NPI

Yolanda Marie Roche, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1295397206
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009578A Issued in IN
Practice address
1001 N Hickory Rd Ste 3
South Bend, IN 46615-3700
Phone
(574) 220-4778
NPI assigned
Jul 1, 2019
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71009578A IN Primary
General Practice Registered Nurse 163WG0000X 4704267670 MI
General Practice Registered Nurse 163WG0000X 28165052A IN

Addresses

Primary practice location

1001 N Hickory Rd Ste 3
South Bend, IN 46615-3700

Mailing address

1001 N Hickory Rd Ste 3
South Bend, IN 46615-3700
Phone (574) 220-4778

Other identifiers 1

IdentifierTypeStateIssuer
71009578BOtherINCONTROLLED SUBSTANCES REGISTRATION

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
I20210721003590 IN Practitioner - Nurse Practitioner 5890198329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psych Pointe, LLCGroup PAC ID 1557764016, 8 clinicians

Practice addresses (Care Compare)

113 Lincolnway E
Mishawaka, IN 46544-2016
Phone (574) 314-5987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
4704267670MIMDGeneral Practice Registered Nurse
71009578AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Pointe LLC CurrentSince Jun 30, 2021 Accepting new patients
Lincoln Counseling, PC PastSince Mar 30, 2022 Accepting new patients

Locations

113 Lincolnway E
Mishawaka, IN 46544
Phone (574) 255-4976

1001 N Hickory Rd
Ste 3
South Bend, IN 46615
Phone (574) 232-3100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24035/brand/1/csg/1/fhir/r4
  • Direct secure messaging: yolanda.roche.1@24035.direct.athenahealth.com

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295397206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N HICKORY RD STE 3",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153700",
            "telephone_number": "574-220-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N HICKORY RD STE 3",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153700",
            "telephone_number": "574-220-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "YOLANDA",
        "middle_name": "MARIE",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009578A",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704267670",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IN",
            "license": "28165052A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCES REGISTRATION",
            "identifier": "71009578B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.