Individual provider Active NPI

Ludmila Pichugena-Emerson, NP-C

  • Adult Health Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1447669304
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71005029A Issued in IN
Practice address
211 N Eddy St.
South Bend, IN 46617-3096
Phone
(574) 237-9331
Fax
(574) 237-9252
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71005029A IN Primary

Addresses

Primary practice location

211 N Eddy St.
South Bend, IN 46617-3096

Mailing address

211 N Eddy St.
South Bend, IN 46617-3096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

303 N Nappanee St
Elkhart, IN 46514-2066

303 S Nappanee St
Elkhart, IN 46514-2066

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71005029AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Indiana, LLC CurrentSince Feb 20, 2023 Accepting new patients
Privia Medical Group Indiana, LLC Current Accepting new patients

Locations

303 S Nappanee St
Elkhart, IN 46514

410 Park Pl
#A
Mishawaka, IN 46545
Phone (574) 252-0667

Organizations & group practices 2

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 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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1447669304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST.",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST.",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173096",
            "telephone_number": "574-237-9331",
            "fax_number": "574-237-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHUGENA-EMERSON",
        "first_name": "LUDMILA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71005029A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.