Individual provider Active NPI

Tesha Geraghty, FNP

  • Family Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1457002644
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012089A Issued in IN
Practice address
200 Alfred St
Michigan City, IN 46360
Phone
(219) 872-6200
Fax
(219) 879-2915
NPI assigned
Jan 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 71012089A IN
Family Nurse Practitioner 363LF0000X 71012089A IN Primary

Addresses

Primary practice location

200 Alfred St
Michigan City, IN 46360

Mailing address

710 Franklin St Ste 200
Michigan City, IN 46360-3564
Phone (219) 872-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220307001200 IN Practitioner - Nurse Practitioner 5698169753 Reassigns benefits to 1 organization
I20250411000942 IL Practitioner - Nurse Practitioner 5698169753 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71012089AINMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical CurrentSince Sep 2, 2024 Accepting new patients
Access Community Health Network CurrentSince Feb 10, 2025 Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

600 W Fulton St
Ste 300
Chicago, IL 60661

152 W Lincoln Hwy
Chicago Hts, IL 60411
Phone (708) 754-9687

155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437

402 19th St
Tell City, IN 47586
Phone (812) 547-3427

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.

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1457002644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 FRANKLIN ST STE 200",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603564",
            "telephone_number": "219-872-6200",
            "fax_number": "219-879-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ALFRED ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "46360",
            "telephone_number": "219-872-6200",
            "fax_number": "219-879-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERAGHTY",
        "first_name": "TESHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71012089A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012089A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.