Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jonathan Michael Fansler, NP

Individual provider Nurse Practitioner · NPI 1366193377

Mr. Jonathan Michael Fansler, NP is a Nurse Practitioner in Lagrange, Indiana. Qualified in 2021, 5 years ago. Practices with Northeast Internal Medicine Associates, PC, a 53-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
5
Licensed in
IN
In the registry since
2022
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

2500 N Detroit St
Lagrange, IN 46761-1158
Phone: (260) 463-2133
Fax: (260) 463-3775
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11050 Parkview Circle Dr, Fort Wayne, IN 46845-1739 — (260) 266-7100

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71012167A (IN)
Registered Nurse Taxonomy 163W00000X · Licence 28234112A (IN)

Record details

NPI number1366193377
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 11, 2022
Last updated in NPPESSeptember 19, 2025
Certification dateSeptember 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northeast Internal Medicine Associates, Pc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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