Active NPI
Nancy Anne Inquilla, MSN, FNP
- Family Nurse Practitioner
- Mishawaka, IN
National Provider Identifier
1578534038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71000991A
- Practice address
- 316 Indian Ridge Blvd
Mishawaka, IN 46545-9034 - Phone
- (800) 635-5516
- NPI assigned
- Jan 31, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000991A | IN | Primary |
Addresses
Primary practice location
316 Indian Ridge Blvd
Mishawaka, IN 46545-9034
Mailing address
3355 Douglas Rd
Suite 300
South Bend, IN 46635-1781
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200805920 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 810 | AK | MD | Professional Counselor |
| 71000991A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Past | Accepting new patients | |
| Raymond E. Andreassen | Past | Accepting new patients | |
| Beacon Medical Group, Inc. | Family | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Beacon Medical Group Schwartz - Wiekamp
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
dba Beacon Medical Group Ireland Road
- Family Medicine Physician
- South Bend, IN
- NPI 1124079330
-
dba Family Medical Center
- Family Medicine Physician
- Delta Junction, AK
- NPI 1366640070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229472000000",
"number": "1578534038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 DOUGLAS RD",
"address_2": "SUITE 300",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 INDIAN RIDGE BLVD",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465459034",
"telephone_number": "800-635-5516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INQUILLA",
"first_name": "NANCY",
"middle_name": "ANNE",
"credential": "MSN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-31",
"last_updated": "2008-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71000991A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200805920",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.