Individual provider Active NPI

Melissa Christine Quimby, NP

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1508163999
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003571A Issued in IN
Practice address
100 Navarre PL Ste 5570
South Bend, IN 46601-1169
Phone
(574) 647-2550
Fax
(574) 647-1129
NPI assigned
Feb 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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 71003571A IN Primary

Addresses

Primary practice location

100 Navarre PL Ste 5570
South Bend, IN 46601-1169

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-2550

Other identifiers 1

IdentifierTypeStateIssuer
201017700MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address QUIMBY@mybeacon.cernerdirect.com

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
I20110503000057 IN Practitioner - Nurse Practitioner 2264617588 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003571AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. CurrentSince Aug 22, 2019 Accepting new patients
Beacon Medical Group Inc CurrentSince Aug 22, 2019 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Past Accepting new patients

Locations

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

100 Navarre Pl
Ste 5550
South Bend, IN 46601
Phone (574) 234-5123

100 Navarre Pl
Ste 5570
South Bend, IN 46601
Phone (574) 233-6620

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

Interoperability endpoints

  • Direct secure messaging: quimby@mybeacon.cernerdirect.com
  • Direct secure messaging: melissaquimby@beacon.allscriptsdirect.net

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1508163999",
    "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": "574-647-2550",
            "fax_number": "574-647-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL STE 5570",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011169",
            "telephone_number": "574-647-2550",
            "fax_number": "574-647-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIMBY",
        "first_name": "MELISSA",
        "middle_name": "CHRISTINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-21",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003571A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201017700",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "QUIMBY@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Navarre Pl",
            "address_2": "Suite 5550",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.