Nikole Pennington, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71007753A Issued in IN

Practice address

1225 E Coolspring Ave
Michigan City, IN 46360-6312

Phone

(219) 874-5020

NPI assigned

Jan 26, 2018

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nikole.pennington@laportehosp.cernerdirect.com

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.

• Healthlinc, Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1528262581
  Medicare reassignment NPD
• La Porte Clinic Company LLC

  • Internal Medicine Physician
  • Valparaiso, IN
  • NPI 1568829224
  Medicare reassignment NPD
• Healthlinc, Inc

  • Federally Qualified Health Center (FQHC)
  • La Porte, IN
  • NPI 1538728399
  NPD
• Healthlinc, Inc

  • Federally Qualified Health Center (FQHC)
  • Morocco, IN
  • NPI 1568354116
  NPD
• La Porte Clinic Company LLC

  • Durable Medical Equipment & Medical Supplies
  • La Porte, IN
  • NPI 1275081788
  NPD

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1427556232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 W GREENLAWN DR",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463508046",
            "telephone_number": "219-851-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-874-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1509 State St",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463503115",
            "country_code": "US",
            "telephone_number": "219-324-3431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "NIKOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007753A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nikole.Pennington@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1509 State St",
            "city": "LA Porte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463503115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Molly Perales, ATC
• Irma Perez, COTA
• Personal Caregivers of Michiana, Inc.
• Personalized Dental Center
• David Eugene Peters, DDS

• Family Nurse Practitioner in Michigan City, IN
• Providers in Michigan City, 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 Sep 16, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.