ANDREA E AHLGRIM, DNP, NNP-BC — NPI 1740061068 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal in SOUTH BEND, IN)

CMS-1500 Box 24J / 33a • NPI

1740061068

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363LN0000X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal

Box 32 Service Location & ZIP+4

615 N MICHIGAN ST 1ST FL HOSPITALIST STE, SOUTH BEND, IN, 46601-1033

✓ 9-Digit EDI 837 ZIP+4 (46601-1033)

Practice Phone & Referral Fax

(574) 647-3050

Fax: (574) 647-1094

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1740061068 (ANDREA E AHLGRIM, DNP, NNP-BC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1740061068` (NPI-1 Individual Practitioner)
Provider / Legal Name	ANDREA E AHLGRIM, DNP, NNP-BC
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal NUCC Code: `363LN0000X` (Nurse Practitioner, Neonatal)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	615 N MICHIGAN ST 1ST FL HOSPITALIST STE, SOUTH BEND, IN, 46601-1033
Practice Telephone / Fax	Tel: (574) 647-3050 \| Fax: (574) 647-1094
Administrative Mailing Address	3245 HEALTH DR STE 100, GRANGER, IN, 46530-1380
Enumeration & Last Sync	Enumerated: 2023-10-12 \| CMS Record Updated: 2024-12-05

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

615 N MICHIGAN ST 1ST FL HOSPITALIST STE, SOUTH BEND, IN, 46601-1033

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Plain-English Taxonomy & CMS Crosswalk (363LN0000X)

What Does Taxonomy Code 363LN0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LN0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Neonatal for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ANDREA E AHLGRIM, DNP, NNP-BC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363LN0000X` — Nurse Practitioner, Neonatal Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Neonatal	State: IN \| License: `71014739A` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ANDREA E AHLGRIM, DNP, NNP-BC (NPI #1740061068)