Individual provider Active NPI

Katrina Schabacker, FNP-BC

  • Family Nurse Practitioner
  • Dyer, IN
National Provider Identifier
1497107114
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006423A Issued in IN
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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 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

IdentifierTypeStateIssuer
71006423AOtherININ LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180910001038 IL Practitioner - Nurse Practitioner 4284929027 Reassigns benefits to 1 organization

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
Bespoke PsychiatryGroup PAC ID 3274951744, 51 clinicians

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

OrganizationSpecialtyStatusNew patients
Bespoke Psychiatry CurrentSince Feb 11, 2026 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.