Individual provider Active NPI

Luke Eichorn, FNP-BC

  • Family Nurse Practitioner
  • Edwardsburg, MI
National Provider Identifier
1629852868
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704383927 Issued in MI
Practice address
27082 W Main St
Edwardsburg, MI 49112
Phone
(269) 246-1375
NPI assigned
Aug 21, 2023
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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 4704383927 MI Primary

Addresses

Primary practice location

27082 W Main St
Edwardsburg, MI 49112

Mailing address

115 E Marion St
Mishawaka, IN 46545-6515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20231206004097 MI Practitioner - Nurse Practitioner 8123477841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthy Cocoon Practice PLLCGroup PAC ID 1355700428, 2 clinicians

Practice addresses (Care Compare)

27082 Main St
Edwardsburg, MI 49112-9334
Phone (269) 246-1375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Cocoon Practice PLLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

27082 Main St
Edwardsburg, MI 49112
Phone (269) 246-1375

Organizations & group practices 1

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 4

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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1629852868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E MARION ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465456515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27082 W MAIN ST",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "49112",
            "telephone_number": "269-246-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHORN",
        "first_name": "LUKE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704383927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsburg, MI

Sources for this page

Verify at the official NPI Registry.