Westgate Medical, LLC
Organization Active NPI Family Nurse Practitioner · Bloomfield, IN
NPI 1679971550 · NPPES record last updated Feb 1, 2017
Key facts
- NPI
- 1679971550
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71002130A (IN)
- Legal business name
- WESTGATE MEDICAL, LLC
- Practice address
- 10858 E State Road 54
Suite #1
Bloomfield, IN 47424-6069 - Phone
- (812) 400-0067
- Fax
- (812) 400-0017
- NPI assigned
- Dec 9, 2014
- Organization subpart
- No
Authorized official
- Name
- Kathi R Robinson
- Title
- Practice Manager
- Phone
- (812) 400-0067
Practitioners 4
-
Jody Lynn Root, FNP-BC
-
Brandy Lynn Anderson, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150720000229 | IN | Part B Supplier - Clinic/Group Practice | 3274846381 |
Receives reassigned benefits from 4 practitioners Practice locations: Bloomfield, IN |
National Provider Directory
Locations
10858 E State Road 54
#1
Bloomfield, IN 47424
Phone (812) 400-0067
7519 S West Gate Rd
Newberry, IN 47449
Phone (812) 400-0067
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | IN | ||
| Family Nurse Practitioner |
363LF0000X | 71002130A | IN | Yes |
Addresses
Primary practice location
10858 E State Road 54
Suite #1
Bloomfield, IN 47424-6069
Mailing address
10858 E State Road 54
Suite #1
Bloomfield, IN 47424-6069
Phone (812) 400-0067
Other providers in Bloomfield, IN
- Elizabeth Sickels
- Jodi Stewart
- Melody Valente
- James C Vandeventer
- Kari Wagner
- Jan Paauwe Weust
- Alice Marie Whalen
- Allison Paige Wininger
All providers in Bloomfield, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.