Individual provider Active NPI

Bancy Mwangi, FNP-BC

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1427828854
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023151887 Issued in IN
Practice address
53779 Generations Dr Ste D
South Bend, IN 46635-1577
Phone
(574) 383-8072
NPI assigned
Jan 5, 2024
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023151887 IN Primary

Addresses

Primary practice location

53779 Generations Dr Ste D
South Bend, IN 46635-1577

Mailing address

53779 Generations Dr Ste D
South Bend, IN 46635-1577
Phone (574) 383-8072

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
I20240311003474 IN Practitioner - Nurse Practitioner 1850737990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group Indiana LLCGroup PAC ID 2365341674, 28 clinicians

Practice addresses (Care Compare)

303 N Nappanee St
Elkhart, IN 46514-2066
Phone 57429632003973

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023151887INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Indiana, LLC CurrentSince Apr 1, 2024 Accepting new patients
Honor Physicians, LLC CurrentSince Apr 1, 2024 Accepting new patients
Privia Medical Group Indiana, LLC Family Current Accepting new patients

Locations

2222 W Lexington Ave
#B
Elkhart, IN 46514
Phone (219) 206-8777

303 S Nappanee St
Elkhart, IN 46514

6915 N Fir Rd
Granger, IN 46530
Phone (574) 234-2191

3809 N Main St
Ste 100
Mishawaka, IN 46545
Phone (574) 520-1700

Interoperability endpoints

  • Direct secure messaging: bancy.mwangi.1@31626.direct.athenahealth.com

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 2

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": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1427828854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53779 GENERATIONS DR STE D",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351577",
            "telephone_number": "574-383-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53779 GENERATIONS DR STE D",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351577",
            "telephone_number": "574-383-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "BANCY",
        "name_prefix": "Dr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "2023151887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.