Reba J Goshert, NP
Individual provider Active NPI Pediatric Nurse Practitioner · Nappanee, IN
NPI 1912103151 · NPPES record last updated Apr 28, 2023
Key facts
- NPI
- 1912103151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 71000002A (IN)
- Practice address
- 2102 N Main St
Nappanee, IN 46550-9310 - Phone
- (574) 862-2165
- Fax
- (574) 862-4112
- NPI assigned
- Jun 25, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- 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 Inc
Practice addresses (Care Compare)
207 N Elkhart St
Beacon Medical Group Wakarusa
Wakarusa, IN 46573-9729
Phone (574) 862-2165
Hospital & facility affiliations
- Elkhart General Hospital
- Goshen Hospital
- Community Hospital of Bremen Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090223000457 | IN | Practitioner - Nurse Practitioner | 6709941974 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000002A | IN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group Inc | Current |
Accepting new patients | |
| Beacon Medical Group, Inc. | Current | 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
- goshert@mybeacon.cernerdirect.com
- rgoshert@mybeacon.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 71000002A | IN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200937920 | Medicaid | IN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | GOSHERT@mybeacon.cernerdirect.com |
Other providers in Nappanee, IN
- Family Spinal Adjusting, LLC
- Tricia K Foster
- Larry Alan Fredericks
- Jillian R Geiger
- Goshen Health System, Inc
- Loren Jay Hartman
- Matthew Shawn Hauck
- Erick James Heckaman
- Dawn L Heckathorn
- Karen Leigh Holmes
All providers in Nappanee, IN · Pediatric Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.