Individual provider Active NPI

Michelle Vazquez

  • Family Nurse Practitioner
  • Kokomo, IN
National Provider Identifier
1518502897
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009629A Issued in IN
Practice address
3505 S Reed Rd
Kokomo, IN 46902-3838
Phone
(765) 776-5500
NPI assigned
Nov 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71009629A IN Primary
Family Nurse Practitioner 363LF0000X 28195734A IN

Addresses

Primary practice location

3505 S Reed Rd
Kokomo, IN 46902-3838

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

3118 S LaFountain St
Kokomo, IN 46902-3710
Phone (765) 864-4160

Other identifiers 1

IdentifierTypeStateIssuer
300034136MedicaidIN

Other names 1

  • Michelle White Former name

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
I20200120000507 IN Practitioner - Nurse Practitioner 7416382536 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

3505 S Reed Rd
Kokomo, IN 46902-3838
Phone (765) 776-5500

3719 S Western Ave
Marion, IN 46953-4828
Phone (765) 293-8485

4152 W State Rd
Suite 56
Hanover, IN 47243-9070
Phone (901) 351-1791

Hospital & facility affiliations

  • Community Howard Regional Health Inc. Hospital, Kokomo, IN, CCN 150007
  • Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
  • Marion General Hospital Hospital, Marion, IN, CCN 150011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28195734AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Mar 18, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Mar 18, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Dec 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Dec 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2025 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1159 W Jefferson St
Ste 204
Franklin, IN 46131

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

3611 S Reed Rd
Ste 103
Kokomo, IN 46902
Phone (765) 776-5500

3505 S Reed Rd
Kokomo, IN 46902
Phone (765) 453-8666

Interoperability endpoints

  • Direct secure messaging: mvazquez583087@ecommunitydirect.com

Organizations & group practices 7

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 6

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": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1518502897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 S REED RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023838",
            "telephone_number": "765-776-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3118 S LaFountain St",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469023710",
            "country_code": "US",
            "telephone_number": "765-864-4160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009629A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28195734A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300034136",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "WHITE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.