Mara Nicole Humberg, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71011419A Issued in IN

Practice address

2316 South St
Lafayette, IN 47904-2971

Phone

(765) 742-1567

Fax

(765) 742-2750

NPI assigned

Oct 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mara Nicole Lavelle Former name

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhumberg@direct.iuhealth.org

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.

• Arnett Clinic, LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1164490843
  Medicare reassignment NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment NPD
• Arnett Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
  • NPI 1699839563
  NPD
• Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
  • NPI 1881655090
  NPD
• Riggs Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1386876233
  NPD (past)

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1760089445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042138",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 SOUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042971",
            "telephone_number": "765-742-1567",
            "fax_number": "765-742-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBERG",
        "first_name": "MARA",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71011419A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28224434A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "LAVELLE",
            "middle_name": "NICOLE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin David Hufford, MD
• Karen E. Hughes, CNS
• Ying-Kei Hui, MD
• Marlene Huizar, NP
• Tara J Hulsey, LCSW, LMFT, LMHC
• Rebecca A Humphrey, LMHC
• Marlene R Hunley
• Ginger Hunt-Goins, MSW, LSW
• Kevin M Hunt, MD
• Ashlyn Hurych, RBT

• Pediatric Nurse Practitioner in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.