Individual provider Active NPI

Heather A Carroll, FNP-BC

  • Family Nurse Practitioner
  • Elkhart, IN
National Provider Identifier
1689429854
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015192A Issued in IN
Practice address
2405 W Lexington Ave
Elkhart, IN 46514-1417
Phone
(574) 524-7575
Fax
(574) 524-7575
NPI assigned
Apr 22, 2024
Last updated
May 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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 71015192A IN Primary

Addresses

Primary practice location

2405 W Lexington Ave
Elkhart, IN 46514-1417

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

1215 Lawn Ave Ste 110
Elkhart, IN 46514-2493
Phone (574) 524-7570

Other practice location 2

100 Navarre Pl Ste 4470
South Bend, IN 46601-1168
Phone (574) 647-1405

Other practice location 3

202 Lincolnway E Ste 201
Mishawaka, IN 46544-2079
Phone (574) 584-2812

Other identifiers 1

IdentifierTypeStateIssuer
300093448MedicaidIN

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
I20250314000768 IN Practitioner - Nurse Practitioner 9234543927 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71015192AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. Family CurrentSince Apr 28, 2025 Accepting new patients
Beacon Medical Group Inc CurrentSince Apr 28, 2025 Accepting new patients
Northern Indiana Maternal and Child Health Network, Inc Past Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

1215 Lawn Ave
Ste 110
Elkhart, IN 46514
Phone (574) 524-7570

2405 W Lexington Ave
Elkhart, IN 46514
Phone (574) 295-8805

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

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

202 Lincolnway E
Ste 201
Mishawaka, IN 46544
Phone (574) 584-2812

100 Navarre Pl
Ste 4470
South Bend, IN 46601
Phone (574) 647-1300

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1689429854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 W LEXINGTON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141417",
            "telephone_number": "574-524-7575",
            "fax_number": "574-524-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lawn Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142493",
            "country_code": "US",
            "telephone_number": "574-524-7570",
            "fax_number": "574-524-7571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Navarre Pl Ste 4470",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011168",
            "country_code": "US",
            "telephone_number": "574-647-1405",
            "fax_number": "574-647-3970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Lincolnway E Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465442079",
            "country_code": "US",
            "telephone_number": "574-584-2812",
            "fax_number": "574-584-2813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "HEATHER",
        "middle_name": "A",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015192A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300093448",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.