Individual provider Active NPI

Teresiah W. Mwangi-Riley

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1952947574
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009551A Issued in IN
Practice address
1901 W Western Ave Ste B
South Bend, IN 46619-3570
Phone
(574) 234-9033
Fax
(574) 847-7200
NPI assigned
Nov 19, 2019
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71009551A IN
Family Nurse Practitioner 363LF0000X 71009551A IN Primary

Addresses

Primary practice location

1901 W Western Ave Ste B
South Bend, IN 46619-3570

Mailing address

8003 Castleway Dr
Indianapolis, IN 46250-1946
Phone (317) 576-1335

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
I20241202002663 IN Practitioner - Nurse Practitioner 2365977253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana Health Centers IncGroup PAC ID 3971599473, 63 clinicians

Practice addresses (Care Compare)

1010 N Bendix Dr
Ihc Bendix Health Center
South Bend, IN 46628-1925
Phone (574) 245-4980

1901 W Western Ave B
Ihc at Southbend
South Bend, IN 46619-3570
Phone (574) 234-9033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71009551AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Health Centers, Inc. CurrentSince Nov 22, 2024 Accepting new patients
Indiana Health Centers Inc CurrentSince Nov 22, 2024 Accepting new patients
Indiana Health Centers, Inc. Family Past Accepting new patients
Windsor Workcare PastSince Nov 1, 2019 Accepting new patients
Indiana Health Centers, Inc. Past Accepting new patients
Dorwyn C Collier, P.C. PastSince Nov 1, 2019 Accepting new patients
Indiana Health Centers, Inc. Family Past Accepting new patients
Indiana Health Centers, Inc Past Accepting new patients

Locations

8003 Castleway Dr
Indianapolis, IN 46250
Phone (317) 576-1335

1010 N Bendix Dr
South Bend, IN 46628
Phone (574) 245-4980

1901 W Western Ave
Ste B
South Bend, IN 46619
Phone (574) 234-9033

765 S Michigan St
South Bend, IN 46601
Phone (574) 235-7990

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1952947574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 CASTLEWAY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501946",
            "telephone_number": "317-576-1335",
            "fax_number": "317-343-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W WESTERN AVE STE B",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466193570",
            "telephone_number": "574-234-9033",
            "fax_number": "574-847-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANGI-RILEY",
        "first_name": "TERESIAH",
        "middle_name": "W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009551A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009551A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.