Active NPI
Mallory Hanewich, FNP-C
- Nurse Practitioner
- Wheatfield, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71015853A
- Practice address
- 3988 W State Road 10
Wheatfield, IN 46392-9251 - Phone
- (219) 987-3581
- NPI assigned
- Oct 17, 2024
- Last updated
- Oct 17, 2024
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71015853A | IN | Primary |
Addresses
Primary practice location
3988 W State Road 10
Wheatfield, IN 46392-9251
Mailing address
7402 N 400 W
Rensselaer, IN 47978-7528
Phone (219) 869-3675
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, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3988 W State Rd
Suite 10
Wheatfield, IN 46392-9251
Phone (219) 270-3400
650 Dickinson Rd
Chesterton, IN 46304-3387
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Porter Physician Services LLC | Nurse Practitioner | Current | Accepting new patients |
| Porter Physician Services LLC | Past | Accepting new patients |
Locations
650 Dickinson Rd
Ste A
Chesterton, IN 46304
Phone (219) 926-2133
650 Dickinson Rd
Ste Z
Chesterton, IN 46304
Phone (219) 464-9507
3988 W State Road 10
Wheatfield, IN 46392
Phone (219) 270-3400
Interoperability endpoints
- mallory.hanewich.1@2340.direct.athenahealth.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.
-
- Family Medicine Physician
- Valparaiso, IN
- NPI 1508075680
Nurse Practitioner
-
- Internal Medicine Physician
- Portage, IN
- NPI 1457566309
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Powers Health Rehabilitation Center
- Rehabilitation Hospital
- Crown Point, IN
- NPI 1801301437
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Crown Point, IN
- NPI 1336205798
-
dba Franciscan Home Care
- Home Health Agency
- Hobart, IN
- NPI 1144225491
-
dba Franciscan Healthcare Rensselaer
- Critical Access Hospital
- Rensselaer, IN
- NPI 1932589173
-
dba Northwest Health-Porter
- General Acute Care Hospital
- Valparaiso, IN
- NPI 1215151154
-
- General Acute Care Hospital
- Hobart, IN
- NPI 1558463745
-
dba St Mary Wound Clinic
- General Acute Care Hospital
- Hobart, IN
- NPI 1962504175
-
- General Acute Care Hospital
- Gary, IN
- NPI 1467504555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729123200000",
"number": "1497576052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7402 N 400 W",
"city": "RENSSELAER",
"state": "IN",
"postal_code": "479787528",
"telephone_number": "219-869-3675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3988 W STATE ROAD 10",
"city": "WHEATFIELD",
"state": "IN",
"postal_code": "463929251",
"telephone_number": "219-987-3581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANEWICH",
"first_name": "MALLORY",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-17",
"last_updated": "2024-10-17",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71015853A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheatfield, IN
- Jessica Jean Deboer
- Corinne Michelle Djuric, NP
- Franciscan Health Rensselaer, Inc. (Franciscan Wheatfield Health Center)
- Franciscan Health Rensselaer, Inc. (Franciscan Health and Fitness)
- Franklin-McCallister (Motherly Care)
- Erin A Husch
- Jasper County Hospital (Wheatfield Health Centre)
- Kankakee Valley School Corporation
- Kankakee Vallley School Corporation
- Kathleen Kleefisch, DNP, FNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.