Active NPI
Callie Maria Bushong
- Family Nurse Practitioner
- Elkhart, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71011411A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
Practice addresses (Care Compare)
808 N 3Rd St
Goshen, IN 46528-7100
Phone (547) 534-3300
Hospital & facility affiliations
- Goshen Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71011411A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple City Health Care Center, Inc. | Current | Accepting new patients | |
| Maple City Health Care Center, Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group Inc | Current | 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.
-
- Federally Qualified Health Center (FQHC)
- Goshen, IN
- NPI 1033166095
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Radiation Oncology Physician
- South Bend, IN
- NPI 1770775009
-
- Federally Qualified Health Center (FQHC)
- Goshen, IN
- NPI 1275220303
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Goshen, IN
- NPI 1740268846
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.