NPIMap

Individual provider Active NPI

Susan Free

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1295494326
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28216649A Issued in IN
Practice address
4401 W Western Ave Ste C
South Bend, IN 46619-2645
Phone
(574) 725-7006
Fax
(574) 807-9614
NPI assigned
Dec 16, 2021
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28216649A IN
Family Nurse Practitioner 363LF0000X 28216649A IN Primary

Addresses

Primary practice location

4401 W Western Ave Ste C
South Bend, IN 46619-2645

Mailing address

PO Box 708760
Sandy, UT 84070-8717
Phone (801) 352-9500

Other practice location 1

600 East Blvd
Elkhart, IN 46514-2483
Phone (574) 389-7393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220317001922 IN Practitioner - Nurse Practitioner 9133514748 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SWDC Medical Associates LLCGroup PAC ID 2466716501, 11 clinicians
Mid West Hospital Physicians PLLCGroup PAC ID 1658612098, 18 clinicians

Practice addresses (Care Compare)

1314 E Walnut St
Washington, IN 47501-2860
Phone (812) 254-2760

1808 Sherman Dr
Princeton, IN 47670-1043
Phone (812) 385-3401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
83.98
Improvement activities
40
Cost
76.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28216649AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Indiana PC CurrentSince Feb 15, 2022 Accepting new patients
SWDC Medical Associates LLC CurrentSince Dec 8, 2025 Accepting new patients
Mid West Hospital Physicians, PLLC Nurse Practitioner CurrentSince Jan 13, 2025 Accepting new patients
Oak Street Health Physicians Group, PC Nurse Practitioner Past Accepting new patients

Locations

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

1808 Sherman Dr
Princeton, IN 47670
Phone (812) 385-3401

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1295494326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708760",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708717",
            "telephone_number": "801-352-9500",
            "fax_number": "801-352-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 W WESTERN AVE STE C",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466192645",
            "telephone_number": "574-725-7006",
            "fax_number": "574-807-9614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 East Blvd",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142483",
            "country_code": "US",
            "telephone_number": "574-389-7393",
            "fax_number": "574-389-4890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREE",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28216649A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28216649A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.