Active NPI
Katrina Schabacker, FNP-BC
- Family Nurse Practitioner
- Dyer, IN
National Provider Identifier
1497107114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71006423A
- Practice address
- 15900 W 101St Ave
Dyer, IN 46311-3065 - Phone
- (219) 365-6333
- Fax
- (219) 365-8291
- NPI assigned
- Jul 6, 2016
- Last updated
- Apr 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71006423A | IN | Primary |
Addresses
Primary practice location
15900 W 101St Ave
Dyer, IN 46311-3065
Mailing address
15900 W 101St Ave
Dyer, IN 46311-3065
Phone (219) 365-6333
Other practice location 1
16000 W 101st Ave
Dyer, IN 46311
Phone (219) 365-6333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71006423A | Other | IN | IN LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | katrina.schabacker@mmgsc.eclinicaldirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1203 W Augusta Blvd
Suite 1
Chicago, IL 60642-4327
Phone (773) 248-2255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bespoke Psychiatry | Current | Accepting new patients | |
| Sigma Health PC | Past | Accepting new patients |
Locations
1203 W Augusta Blvd
Ste 1
Chicago, IL 60642
Phone (773) 248-2255
Interoperability endpoints
- katrina.schabacker@mmgsc.eclinicaldirect.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Chicago, IL
- NPI 1952937104
-
- Neurology Physician
- Orland Park, IL
- NPI 1720035843
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1497107114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15900 W 101ST AVE",
"city": "DYER",
"state": "IN",
"postal_code": "463113065",
"telephone_number": "219-365-6333",
"fax_number": "219-365-8291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15900 W 101ST AVE",
"city": "DYER",
"state": "IN",
"postal_code": "463113065",
"telephone_number": "219-365-6333",
"fax_number": "219-365-8291"
}
],
"practiceLocations": [
{
"address_1": "16000 W 101st Ave",
"address_purpose": "LOCATION",
"city": "Dyer",
"state": "IN",
"postal_code": "46311",
"country_code": "US",
"telephone_number": "219-365-6333",
"fax_number": "219-365-8291",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCHABACKER",
"first_name": "KATRINA",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-06",
"last_updated": "2021-04-09",
"certification_date": "2021-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71006423A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IN LICENSE",
"identifier": "71006423A",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "katrina.schabacker@mmgsc.eclinicaldirect.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "15900 W 101st Ave",
"city": "Dyer",
"state": "IN",
"country_code": "US",
"postal_code": "463113065",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Dyer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.