Individual provider Active NPI

Nicole A Scheidler, NP

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1760082002
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28225566A Issued in IN
Practice address
420 W 4TH St Ste 100
Mishawaka, IN 46544-1948
Phone
(574) 307-7673
Fax
(574) 307-7688
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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 28225566A IN Primary

Addresses

Primary practice location

420 W 4TH St Ste 100
Mishawaka, IN 46544-1948

Mailing address

420 W 4TH St Ste 100
Mishawaka, IN 46544-1948
Phone (574) 307-7673

Other names 1

  • Nicole A Doucette Former name

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
I20210113002444 IN Practitioner - Nurse Practitioner 4981017837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

420 W 4TH St
Mishawaka, IN 46544-1948
Phone 57430776734693

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc. Current Accepting new patients
Healthlinc, Inc. CurrentSince Aug 2, 2023 Accepting new patients
Healthlinc, Inc CurrentSince Aug 2, 2023 Accepting new patients

Locations

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

420 W 4th St
Ste 100
Mishawaka, IN 46544
Phone (574) 252-0300

621 Memorial Dr
Ste 402
South Bend, IN 46601
Phone (574) 232-4800

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

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 2

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": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1760082002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W 4TH ST STE 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441948",
            "telephone_number": "574-307-7673",
            "fax_number": "574-307-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 4TH ST STE 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441948",
            "telephone_number": "574-307-7673",
            "fax_number": "574-307-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEIDLER",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28225566A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DOUCETTE",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.