Active NPI
Nicole Ashley Wheeler
- Adult Health Nurse Practitioner
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 71012836A
- Practice address
- 610 N Michigan St Ste 400
South Bend, IN 46601-1081 - Phone
- (574) 647-8120
- Fax
- (574) 647-8111
- NPI assigned
- Jul 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71023836A | IN | |
| Adult Health Nurse Practitioner | 363LA2200X | 71012836A | IN | Primary |
Addresses
Primary practice location
610 N Michigan St Ste 400
South Bend, IN 46601-1081
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Other practice location 1
17475 Dugdale Dr
South Bend, IN 46635-1545
Phone (574) 247-7500
Other practice location 2
610 N Michigan St Ste 306
South Bend, IN 46601-1079
Phone (574) 647-6500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300038057 | Medicaid | IN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
610 N Michigan St
400 BMG Adv Cardiology Specialists
South Bend, IN 46601-1081
Phone (574) 647-8120
Hospital & facility affiliations
- Memorial Hospital of South Bend
- Community Hospital of Bremen Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71023836A | IN | MD | Nurse Practitioner |
| 71012836A | IN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Informe HC Specialists, LLC | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Informe Healthcare LLC | Current | Accepting new patients | |
| Informe Healthcare in, LLC | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
745 N Swope St
Greenfield, IN 46140
Phone (317) 462-9221
2860 Churchman Ave
Indianapolis, IN 46203
Phone (317) 787-3451
8800 Virginia Pl
Merrillville, IN 46410
Phone (219) 736-1310
811 E 12th St
Mishawaka, IN 46544
Phone (574) 249-1917
609 Tanglewood Ln
Mishawaka, IN 46545
Phone (574) 277-2500
1420 E Douglas Rd
Mishawaka, IN 46545
Phone (574) 307-7200
610 N Michigan St
Ste 400
South Bend, IN 46601
Phone (574) 204-7333
17475 Dugdale Dr
South Bend, IN 46635
Phone (574) 247-7500
610 N Michigan St
Ste 306
South Bend, IN 46601
Phone (574) 647-6500
2741 W Layton Ave
Ste 106
Milwaukee, WI 53221
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- South Bend, IN
- NPI 1881971505
-
- Internal Medicine Physician
- Dyer, IN
- NPI 1255917647
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Bremen, IN
- NPI 1568417004
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1346975356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 HEALTH DR STE 100",
"city": "GRANGER",
"state": "IN",
"postal_code": "465301380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 N MICHIGAN ST STE 400",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011081",
"telephone_number": "574-647-8120",
"fax_number": "574-647-8111"
}
],
"practiceLocations": [
{
"address_1": "17475 Dugdale Dr",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466351545",
"country_code": "US",
"telephone_number": "574-247-7500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "610 N Michigan St Ste 306",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466011079",
"country_code": "US",
"telephone_number": "574-647-6500",
"fax_number": "574-647-6518",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHEELER",
"first_name": "NICOLE",
"middle_name": "ASHLEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-22",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71023836A",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IN",
"license": "71012836A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300038057",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.