Individual provider Active NPI

William Hanley, NP

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1659543643
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006238A Issued in IN
Practice address
611 E Douglas Rd Ste 200
Mishawaka, IN 46545-1465
Phone
(574) 335-6060
Fax
(574) 335-0611
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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 71006238A IN Primary

Addresses

Primary practice location

611 E Douglas Rd Ste 200
Mishawaka, IN 46545-1465

Mailing address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-8707

Other practice location 1

621 Memorial Dr
Ste 502
South Bend, IN 46601-1075
Phone (574) 647-5875

Other practice location 2

6913 N Main St
Granger, IN 46530-8039
Phone (574) 647-1500

Other practice location 3

1815 E Ireland Rd
South Bend, IN 46614-2845
Phone (574) 647-1750

Other practice location 4

3301 County Road 6 E
Elkhart, IN 46514-7673
Phone (574) 266-5342

Other identifiers 1

IdentifierTypeStateIssuer
201258990MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IN2 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
I20160111000986 TX Practitioner - Nurse Practitioner 3274602073 Reassigns benefits to 1 organization
I20160628002753 IN Practitioner - Nurse Practitioner 3274602073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

611 E Douglas Rd
Mishawaka, IN 46545-1465
Phone (574) 335-6060

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006238AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Indiana Emergency Physicians, LLP CurrentSince Jun 28, 2020 Accepting new patients
Saint Joseph Regional Medical Center, Inc. CurrentSince May 18, 2025 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family CurrentSince May 18, 2025 Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Dec 14, 2015 Accepting new patients
Columbia Valley Emergency Physicians LLC Past Accepting new patients
Washington Em-I Medical Services PC Past Accepting new patients
Careplus Medical Centers, Inc Past Accepting new patients
Seahurst Pediatrics PLLC Past Accepting new patients

Locations

1007 Lincolnway
Laporte, IN 46350
Phone (219) 325-5474

611 E Douglas Rd
Ste 200
Mishawaka, IN 46545
Phone (574) 272-5347

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

Interoperability endpoints

  • Direct secure messaging: whanley4240255@direct.trinity-health.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1659543643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451465",
            "telephone_number": "574-335-6060",
            "fax_number": "574-335-0611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Memorial Dr",
            "address_2": "Ste 502",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011075",
            "country_code": "US",
            "telephone_number": "574-647-5875",
            "fax_number": "574-647-5878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6913 N Main St",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-1500",
            "fax_number": "574-243-4306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1815 E Ireland Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142845",
            "country_code": "US",
            "telephone_number": "574-647-1750",
            "fax_number": "574-647-1748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3301 County Road 6 E",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465147673",
            "country_code": "US",
            "telephone_number": "574-266-5342",
            "fax_number": "574-266-5847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "WILLIAM",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006238A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201258990",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.