Andrea Rose Borders, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

28161579A Issued in IN

Practice address

53800 Generations Dr
South Bend, IN 46635-1543

Phone

(574) 273-3880

Fax

(574) 271-0918

NPI assigned

Sep 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Uthman Cavallo, MD, LLC

  • Obstetrics & Gynecology Physician
  • South Bend, IN
  • NPI 1093152589

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1588065585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53800 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351543",
            "telephone_number": "574-273-3880",
            "fax_number": "574-271-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53800 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351543",
            "telephone_number": "574-273-3880",
            "fax_number": "574-271-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDERS",
        "first_name": "ANDREA",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28161579A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantel Boone
• Shirley Bootz, LDH
• Janice Marie Bopp, PHARMD
• Paula K Bopp, MSW
• Valerie A Borden, MS
• Susanne Borders
• Madison Noelle Borger, DPT
• Kristina Borkholder
• Diann Roseanne Bryanna Bostic
• David John Botkin, PHD

• Nurse Practitioner in South Bend, IN
• Providers in South Bend, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.

Verify at the official NPI Registry.