Individual provider Active NPI

Linda S Holcomb, MSN, FNP-C

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1679733208
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71002673A Issued in IN
Practice address
615 Fulmer Rd
Mishawaka, IN 46544-6911
Phone
(574) 252-3085
Fax
(574) 255-4342
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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 71002673A IN Primary

Addresses

Primary practice location

615 Fulmer Rd
Mishawaka, IN 46544-6911

Mailing address

615 Fulmer Rd
Mishawaka, IN 46544-6911
Phone (574) 252-3085

Other identifiers 2

IdentifierTypeStateIssuer
236030OtherMEDICARE LEGACY
200332960MedicaidIN

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
I20080925000591 IN Practitioner - Nurse Practitioner 2264509785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Healthcare LLCGroup PAC ID 1254331184, 9 clinicians

Practice addresses (Care Compare)

303 S Main St
200 Michiana Medical and Specialty Clinic
Mishawaka, IN 46544-2160
Phone (574) 400-0188

9301 Connecticut Dr
Merrillville, IN 46410-7173

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Unity Physicians Hospital Hospital, Mishawaka, IN, CCN 150177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14141TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Healthcare, LLC CurrentSince Dec 15, 2019 Accepting new patients
Pinnacle Healthcare LLC CurrentSince Dec 15, 2019 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Past Accepting new patients

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

8550 Broadway
Merrillville, IN 46410
Phone (219) 736-8888

303 S Main St
Ste 111
Mishawaka, IN 46544
Phone (219) 255-9553

303 S Main St
Ste 200
Mishawaka, IN 46544
Phone (574) 256-9790

303 S Main St
Mishawaka, IN 46544
Phone (347) 541-4133

Organizations & group practices 3

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 6

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1679733208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 FULMER RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465446911",
            "telephone_number": "574-252-3085",
            "fax_number": "574-255-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FULMER RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465446911",
            "telephone_number": "574-252-3085",
            "fax_number": "574-255-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "LINDA",
        "middle_name": "S",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002673A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY",
            "identifier": "236030",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200332960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.