Individual provider Active NPI

Callie Maria Bushong

  • Family Nurse Practitioner
  • Elkhart, IN
National Provider Identifier
1497421986
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011411A Issued in IN
Practice address
1215 Lawn Ave Ste 120
Elkhart, IN 46514-2450
Phone
(574) 523-2733
Fax
(574) 523-3251
NPI assigned
Aug 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 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 71011411A IN
Family Nurse Practitioner 363LF0000X 71011411A IN Primary

Addresses

Primary practice location

1215 Lawn Ave Ste 120
Elkhart, IN 46514-2450

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3437

Other practice location 1

808 N 3rd St
Goshen, IN 46528-7100
Phone (574) 534-0088

Other practice location 2

621 Memorial Dr Ste 100
South Bend, IN 46601-1063
Phone (574) 647-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Mychart Direct

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
I20211014003268 IN Practitioner - Nurse Practitioner 2264830611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple City Health Care Center IncGroup PAC ID 2163569401, 29 clinicians

Practice addresses (Care Compare)

808 N 3Rd St
Goshen, IN 46528-7100
Phone (547) 534-3300

Hospital & facility affiliations

  • Goshen Hospital Hospital, Goshen, IN, CCN 150026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71011411AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maple City Health Care Center, Inc. CurrentSince Sep 27, 2021 Accepting new patients
Maple City Health Care Center, Inc CurrentSince Sep 27, 2021 Accepting new patients
Beacon Medical Group, Inc. CurrentSince Sep 8, 2025 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Sep 8, 2025 Accepting new patients

Locations

1215 Lawn Ave
Ste 120
Elkhart, IN 46514
Phone (574) 523-2733

808 N 3rd St
Goshen, IN 46528
Phone (574) 534-0088

213 Middlebury St
Goshen, IN 46528
Phone (574) 534-0088

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

621 Memorial Dr
Ste 100
South Bend, IN 46601
Phone (574) 647-1100

Organizations & group practices 5

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 1

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1497421986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LAWN AVE STE 120",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142450",
            "telephone_number": "574-523-2733",
            "fax_number": "574-523-3251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465287100",
            "country_code": "US",
            "telephone_number": "574-534-0088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "621 Memorial Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011063",
            "country_code": "US",
            "telephone_number": "574-647-1100",
            "fax_number": "574-647-3148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSHONG",
        "first_name": "CALLIE",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71011411A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011411A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Mychart",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "808 N 3rd St",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465287100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.