Individual provider Active NPI

Michelle Hart

  • Nurse Practitioner
  • Marion, IN
National Provider Identifier
1356709604
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71006107A Issued in IN
Practice address
1399 N Baldwin Avenue
Marion, IN 46952-2561
Phone
(765) 660-7550
Fax
(765) 662-4467
NPI assigned
Feb 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006107A IN
Nurse Practitioner 363L00000X 71006107A IN Primary

Addresses

Primary practice location

1399 N Baldwin Avenue
Marion, IN 46952-2561

Mailing address

330 N Wabash Avenue
Ste G20
Marion, IN 46952-2600
Phone (765) 660-7616

Other practice location 1

330 N Wabash Ave Ste 470
Marion, IN 46952-2685
Phone (765) 660-7550

Other identifiers 2

IdentifierTypeStateIssuer
000000996990OtherINANTHEM
201348890MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michelle.hart@mgh.eclinicaldirectplus.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
I20160404001499 IN Practitioner - Nurse Practitioner 9739486838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

1130 N Baldwin Ave
Marion, IN 46952-2536
Phone (765) 660-7480

1136 N Baldwin Ave
Marion, IN 46952-2536
Phone (765) 660-7440

4781 Kaybee Dr
Gas City, IN 46933-6607
Phone (765) 660-7840

Hospital & facility affiliations

  • Marion General Hospital Hospital, Marion, IN, CCN 150011

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006107AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marion General Hospital CurrentSince Mar 7, 2016 Accepting new patients
Marion General Hospital CurrentSince Mar 7, 2016 Accepting new patients
Marion General Hospital Current Accepting new patients

Locations

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

330 N Wabash Ave
Ste 470
Marion, IN 46952
Phone (765) 455-8822

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

1136 N Baldwin Ave
Marion, IN 46952
Phone (765) 622-1245

1399 N Baldwin Ave
Marion, IN 46952
Phone (765) 651-2620

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1356709604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH AVENUE",
            "address_2": "STE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522600",
            "telephone_number": "765-660-7616",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 N BALDWIN AVENUE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522561",
            "telephone_number": "765-660-7550",
            "fax_number": "765-662-4467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 N Wabash Ave Ste 470",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IN",
            "postal_code": "469522685",
            "country_code": "US",
            "telephone_number": "765-660-7550",
            "fax_number": "765-662-4467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006107A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006107A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000996990",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201348890",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michelle.hart@mgh.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1399 N Baldwin Avenue",
            "city": "Marion",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469522561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.