Alisha Noel Mack, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28169564A Issued in IN

Practice address

813 S Michigan St
South Bend, IN 46601-3102

Phone

(574) 283-5572

Fax

(574) 283-5571

NPI assigned

Jun 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

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.

• Rhyme & Reason Ministry, Inc.

  • Social Worker
  • South Bend, IN
  • NPI 1750043915
  NPD (past)

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1710115654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466013102",
            "telephone_number": "574-283-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466013102",
            "telephone_number": "574-283-5572",
            "fax_number": "574-283-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ALISHA",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28169564A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200962090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamesha Mabrey
• Laura Theresa Mabry, MSN, CNM
• Megan Lee Mace, PA-C, ATC
• Douglas N Macgregor, D.O.
• Michaela Macinnis, RBT
• Ken Mack, PTA
• Dauvanique Shion Mackey, RBT
• Sarah Mackin
• Maria Macri
• Rehema Madamu

• Family Nurse Practitioner in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.