Individual provider Active NPI

Reba J Goshert, NP

  • Pediatric Nurse Practitioner
  • Nappanee, IN
National Provider Identifier
1912103151
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71000002A Issued in IN
Practice address
2102 N Main St
Nappanee, IN 46550-9310
Phone
(574) 862-2165
Fax
(574) 862-4112
NPI assigned
Jun 25, 2007
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 71000002A IN Primary

Addresses

Primary practice location

2102 N Main St
Nappanee, IN 46550-9310

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610

Other practice location 1

207 N Elkhart St
Wakarusa, IN 46573-9729
Phone (574) 862-2165

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address GOSHERT@mybeacon.cernerdirect.com

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
I20090223000457 IN Practitioner - Nurse Practitioner 6709941974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana Medical College, School of Medicine of Purdue University, 1993
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)

207 N Elkhart St
Beacon Medical Group Wakarusa
Wakarusa, IN 46573-9729
Phone (574) 862-2165

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000002AINMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jan 1, 2014 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

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

2102 N Main St
Nappanee, IN 46550
Phone (574) 862-2165

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

207 N Elkhart St
Wakarusa, IN 46573
Phone (574) 862-2165

Interoperability endpoints

  • Direct secure messaging: goshert@mybeacon.cernerdirect.com
  • Direct secure messaging: rgoshert@mybeacon.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1912103151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 N MAIN ST",
            "city": "NAPPANEE",
            "state": "IN",
            "postal_code": "465509310",
            "telephone_number": "574-862-2165",
            "fax_number": "574-862-4112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 N Elkhart St",
            "address_purpose": "LOCATION",
            "city": "Wakarusa",
            "state": "IN",
            "postal_code": "465739729",
            "country_code": "US",
            "telephone_number": "574-862-2165",
            "fax_number": "574-862-4112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSHERT",
        "first_name": "REBA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71000002A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GOSHERT@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "207 N Elkhart St",
            "city": "Wakarusa",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465739729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nappanee, IN

Sources for this page

Verify at the official NPI Registry.