Individual provider Active NPI

Lisa R Hodge, FNP-C

  • Family Nurse Practitioner
  • Muncie, IN
National Provider Identifier
1629448691
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71005819A Issued in IN
Practice address
5501 W Bethel Ave
Muncie, IN 47304-8513
Phone
(765) 286-3900
Fax
(765) 286-1915
NPI assigned
Oct 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 71005819A IN Primary

Addresses

Primary practice location

5501 W Bethel Ave
Muncie, IN 47304-8513

Mailing address

1200 W White River Blvd
Muncie, IN 47303-4988
Phone (877) 668-5621

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LHODGE1@direct.iuhealth.org

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
I20200529002167 IN Practitioner - Nurse Practitioner 8123449147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

5501 W Bethel Ave
Muncie, IN 47304-8513
Phone (765) 286-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71005819AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Family CurrentSince Oct 1, 2025 Accepting new patients
Indiana University Health Ball Memorial Physicians, Inc. CurrentSince May 18, 2020 Accepting new patients

Locations

3832 Solutions Ctr
Chicago, IL 60677

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1500 Neely Ave
Muncie, IN 47306
Phone (765) 285-1079

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

5501 W Bethel Ave
Muncie, IN 47304
Phone (765) 741-2957

Interoperability endpoints

  • Direct secure messaging: lhodge1@direct.iuhealth.org

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.

Hospital & facility affiliations 1

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": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1629448691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473048513",
            "telephone_number": "765-286-3900",
            "fax_number": "765-286-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-02",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005819A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LHODGE1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "5501 W Bethel Ave",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473048513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.