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NORTHEAST INTERNAL MEDICINE
NPI 1366859779
Nurse Practitioner - Primary Care in Lagrange, IN

Active since July 17, 2014
2500 N DETROIT ST, LAGRANGE, IN 46761(260) 463-2133 Get Directions Write a Review

NPPES record last updated: February 27, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Northeast Internal Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST INTERNAL MEDICINE (NPI 1366859779) is a healthcare organization registered as a primary care in Lagrange, Indiana and active in the NPI registry since July 2014. The organization maintains a secondary practice location in Kendallville and lists Tara Gilmore, Business Office Manager, as its authorized official.

NPPES Registry Identity

NPI1366859779
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameNORTHEAST INTERNAL MEDICINE
Location Address2500 N DETROIT STLagrange, IN 46761-1158
Mailing AddressPo Box 236Lagrange, IN 46761-0236
Phone(260) 463-2133
Organization SubpartNo
Authorized OfficialTara GilmoreBusiness Office Manager · (260) 463-2133
Enumeration DateJuly 17, 2014
Last NPPES UpdateFebruary 27, 2019
✔ NPI 1366859779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in IN · 71004993A
2500 N DETROIT ST, Lagrange, IN 46761
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Secondary Practice Location 1

Location 1610 N Sawyer RdKendallville, IN 46755-2566 · Phone (260) 347-5592 · Fax (260) 347-5155

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHELSEA LAUREN MAUCHER NP
Nurse Practitioner (Acute Care)
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133
DR. SHILPA KASHYAP MD
Radiology (Diagnostic Radiology)
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133
BLAKE WEIMER NP
Nurse Practitioner (Family)
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133
VIJAY G.T. KAMINENI M.D.
Internal Medicine
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133
RYLEE HACKWORTH PA
Physician Assistant (Medical)
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133
MRS. LAUREN FIANDT AGNP-BC
Nurse Practitioner
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133
HASAN ILYAS MD
Internal Medicine
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133
AQSA KHAN MD
Internal Medicine
2500 N DETROIT ST
LAGRANGE, IN 46761
Lagrange County (260) 463-2133

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Internal Medicine's NPI number?

The NPI number for Northeast Internal Medicine is 1366859779. It was assigned to this organization in the NPPES registry on July 17, 2014.

Where is Northeast Internal Medicine located?

Northeast Internal Medicine is located at 2500 N Detroit St, Lagrange, IN 46761. The listed phone number is (260) 463-2133.

What is Northeast Internal Medicine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Northeast Internal Medicine was last updated on February 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.