Hibajene Chisonga

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704262598 Issued in MI

Practice address

1700 Mishawaka Ave
South Bend, IN 46634-7111

Phone

(574) 229-9012

NPI assigned

Nov 27, 2013

Last updated

Mar 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Hospitals at Niles and St Joseph, Inc

  dba Corewell Health Lakeland Hospitals

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1811327943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MISHAWAKA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466151408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MISHAWAKA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466347111",
            "telephone_number": "574-229-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISONGA",
        "first_name": "HIBAJENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704262598",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28181907A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Child Therapy Lab LLC
• Children's Therapy Innovations Inc. (CTI Aging and Rehabilitative Services)
• Chiropractic Health Center, PC
• Chiropractic Health Center, PC
• Larissa M. Chism Buggs, MD
• Hanuma Swetha Chitta, MD
• Felicia Y Chiu, M.D.
• Sarah Chlebowski, BCBA
• Sandra A Cho, D.P.M.
• Choices Recovery

• 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 Mar 7, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.