Heather Gordy, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71012042A Issued in IN

Practice address

611 E Douglas Rd Ste 200
Mishawaka, IN 46545-1465

Phone

(574) 335-6850

Fax

(574) 335-0849

NPI assigned

Oct 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: hstasiak1150273@direct.trinity-health.org

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.

• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717

  IN, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment NPD
• South Bend Emergency Physicians, Inc

  • Emergency Medicine Physician
  • South Bend, IN
  • NPI 1487132114
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Indiana, LLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1720416555

  IN

  Medicare reassignment NPD
• In Hospitalists, LLC

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1225735384
  NPD
• Metro Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD
• Saint Joseph Regional Medical Center, Inc.

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1417619982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451465",
            "telephone_number": "574-335-6850",
            "fax_number": "574-335-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDY",
        "first_name": "HEATHER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012042A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102223470",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300057950",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Joy Good
• Cory Goodson
• Gina Gordenier
• Amanda Gordillo, MA, RD, LD
• Aviva Gordon
• Emily Grace Gouker, PA-C
• Kayla Gowen
• Mary Evelyn Graber, M.D.
• Michael F Grantham, MD
• Kristin Grathen, RN

• Family Nurse Practitioner in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.

Verify at the official NPI Registry.