Individual provider Active NPI

Michelle Diane Hartman, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Burlington, IA
National Provider Identifier
1639418635
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G183675 Issued in IA
Practice address
4715 Sullivan Slough Rd
Burlington, IA 52601-9013
Phone
(319) 752-4000
Fax
(319) 758-6650
NPI assigned
Feb 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277001203 IL
Registered Nurse 163W00000X 091591 IA
Registered Nurse 163W00000X 041333534 IL
Family Nurse Practitioner 363LF0000X A091591 IA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G183675 IA Primary

Addresses

Primary practice location

4715 Sullivan Slough Rd
Burlington, IA 52601-9013

Mailing address

4715 Sullivan Slough Rd
Burlington, IA 52601-9013
Phone (319) 752-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130605000424 IL Practitioner - Nurse Practitioner 3274771175 Reassigns benefits to 1 organization
I20180322000759 IA Practitioner - Nurse Practitioner 3274771175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Young House Family Services IncorporatedGroup PAC ID 4981125911, 3 clinicians

Practice addresses (Care Compare)

4717 Sullivan Slough Rd
Burlington, IA 52601-9013
Phone 31975240001135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
091591IAMDRegistered Nurse
041333534ILMDRegistered Nurse
A091591IAMDFamily Nurse Practitioner
277001203ILMDFamily Nurse Practitioner
G183675IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partnership of Illinois CurrentSince Dec 11, 2020 Accepting new patients
Ottumwa Health Group LLC CurrentSince Apr 2, 2018 Accepting new patients
Community Health Partnership of Illinois CurrentSince Dec 11, 2020 Accepting new patients
Young House Family Services, Incorporated CurrentSince May 1, 2025 Accepting new patients
Ottumwa Health Group LLC CurrentSince Apr 2, 2018 Accepting new patients
Young House Family Services PastSince Nov 18, 2025 Accepting new patients

Locations

4717 Sullivan Slough Rd
Burlington, IA 52601
Phone (319) 752-4000

1001 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 472-4111

1013 Pennsylvania Ave
Ste A
Ottumwa, IA 52501
Phone (641) 683-6868

1011 Pennsylvania Ave
Ste B
Ottumwa, IA 52501
Phone (641) 684-2684

157 S Lincoln Ave
Ste D
Aurora, IL 60505
Phone (630) 859-0015

205 W Randolph St
Ste 2222
Chicago, IL 60606
Phone (312) 795-0000

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/younghouse/r4/
  • Direct secure messaging: michelle.hartmanfnp.p29@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1639418635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 SULLIVAN SLOUGH RD",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019013",
            "telephone_number": "319-752-4000",
            "fax_number": "319-758-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 SULLIVAN SLOUGH RD",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019013",
            "telephone_number": "319-752-4000",
            "fax_number": "319-758-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "MICHELLE",
        "middle_name": "DIANE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001203",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "091591",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041333534",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A091591",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G183675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, IA

Sources for this page

Verify at the official NPI Registry.