Individual provider Active NPI

Heather M Hare

  • Psychiatric/Mental Health Nurse Practitioner
  • Noblesville, IN
National Provider Identifier
1881054575
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71009214A Issued in IN
Practice address
17160 Dragonfly Dr Ste 300
Noblesville, IN 46060-3634
Phone
(765) 752-2242
NPI assigned
Feb 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71009214A IN Primary

Addresses

Primary practice location

17160 Dragonfly Dr Ste 300
Noblesville, IN 46060-3634

Mailing address

17160 Dragonfly Dr Ste 300
Noblesville, IN 46060-3634
Phone (765) 752-2242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71009214AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revitalize Wellness, LLC Psychiatric/Mental Health CurrentSince May 4, 2025 Accepting new patients

Locations

17160 Dragonfly Dr
Ste 300
Noblesville, IN 46060
Phone (765) 252-2242

Interoperability endpoints

  • Direct secure messaging: hhare215393@ecommunitydirect.com

Organizations & group practices 1

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": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1881054575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17160 DRAGONFLY DR STE 300",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460603634",
            "telephone_number": "765-752-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17160 DRAGONFLY DR STE 300",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460603634",
            "telephone_number": "765-752-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARE",
        "first_name": "HEATHER",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71009214A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

Verify at the official NPI Registry.