Individual provider Active NPI

Michelle Jean Streb, RN, FNP-BC

  • Family Nurse Practitioner
  • Granger, IN
National Provider Identifier
1861897688
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71005268A Issued in IN
Practice address
6913 N Main St Ste 300
Granger, IN 46530-8039
Phone
(574) 647-1500
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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 28091767A IN
Family Nurse Practitioner 363LF0000X 71005268A IN Primary

Addresses

Primary practice location

6913 N Main St Ste 300
Granger, IN 46530-8039

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-2129

Other practice location 1

4630 Vistula Rd
Mishawaka, IN 46544-4000
Phone (574) 647-1900

Other identifiers 1

IdentifierTypeStateIssuer
201272400MedicaidIN

Other names 1

  • Michelle Jean Gregory 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
I20150119000739 IN Practitioner - Nurse Practitioner 0143544395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

6913 N Main St
300 Beacon Medical Group Main Street
Granger, IN 46530-8039
Phone (574) 647-1500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc. CurrentSince Dec 15, 2014 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Aug 1, 2022 Accepting new patients
Healthlinc, Inc CurrentSince Dec 15, 2014 Accepting new patients
Beacon Medical Group, Inc. Family CurrentSince Aug 1, 2022 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

6913 N Main St
Ste 300
Granger, IN 46530
Phone (574) 647-1500

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

4630 Vistula Rd
Mishawaka, IN 46544
Phone (219) 254-7200

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

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

1960 Northside Blvd
South Bend, IN 46615
Phone (574) 231-7228

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

951 Transport Dr
Valparaiso, IN 46383
Phone (219) 464-4100

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

Organizations & group practices 6

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 4

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1861897688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6913 N MAIN ST STE 300",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308039",
            "telephone_number": "574-647-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4630 Vistula Rd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465444000",
            "country_code": "US",
            "telephone_number": "574-647-1900",
            "fax_number": "574-647-7289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREB",
        "first_name": "MICHELLE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28091767A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005268A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201272400",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "GREGORY",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.