Individual provider Active NPI

Danielle Elise Feddeler, FNP-C

  • Nurse Practitioner
  • Griffith, IN
National Provider Identifier
1750108726
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71015875A Issued in IN
Practice address
1923 W Glen Park Ave
Griffith, IN 46319-3703
Phone
(219) 922-2535
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28237872A IN
Nurse Practitioner 363L00000X 71015875A IN Primary

Addresses

Primary practice location

1923 W Glen Park Ave
Griffith, IN 46319-3703

Mailing address

1923 W Glen Park Ave
Griffith, IN 46319-3703
Phone (219) 922-2535

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
I20241121002564 IN Practitioner - Nurse Practitioner 5698200061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care, IncGroup PAC ID 5193957595, 31 clinicians
Midwest Express Care 4 LLCGroup PAC ID 4284909615, 64 clinicians

Practice addresses (Care Compare)

1500 Indianapolis Blvd
Schererville, IN 46375-1316
Phone (219) 440-7373

31 E Sibley St
Suite a
Hammond, IN 46320-1725
Phone (219) 802-8800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28237872AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 4 LLC CurrentSince Nov 6, 2024 Accepting new patients
Midwest Express Care, Inc CurrentSince Nov 6, 2024 Accepting new patients
Midwest Express Care 4 LLC CurrentSince Nov 6, 2024 Accepting new patients
Nwi Urgent Care, LLC CurrentSince Nov 6, 2024 Accepting new patients
The Methodist Hospitals, Inc PastSince Nov 6, 2024 Accepting new patients

Locations

1923 W Glen Park Ave
Griffith, IN 46319
Phone (219) 237-2481

31 Sibley St
Ste A
Hammond, IN 46320
Phone (219) 802-8800

8135 Calumet Ave
Munster, IN 46321
Phone (219) 513-2000

1500 US Highway 41
Schererville, IN 46375
Phone (219) 440-7373

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1750108726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 W GLEN PARK AVE",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463193703",
            "telephone_number": "219-922-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 W GLEN PARK AVE",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463193703",
            "telephone_number": "219-922-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDDELER",
        "first_name": "DANIELLE",
        "middle_name": "ELISE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28237872A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71015875A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffith, IN

Sources for this page

Verify at the official NPI Registry.