McKenna A Gottfried

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71007667A Issued in IN

Practice address

3909 New Vision Dr
Fort Wayne, IN 46845-1725

Phone

(260) 425-5500

Fax

(260) 425-5525

NPI assigned

Oct 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN, OH2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgottfried122877@direct.parkviewexchange.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Midwest Community Health Associates, Inc.

  • Family Medicine Physician
  • Bryan, OH
  • NPI 1619915170
  Medicare reassignment NPD
• Midwest Community Health Associates, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Bryan, OH
  • NPI 1942770581
  NPD

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1003328592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451725",
            "telephone_number": "260-425-5500",
            "fax_number": "260-425-5525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "442 W High St",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "OH",
            "postal_code": "435061681",
            "country_code": "US",
            "telephone_number": "419-636-4517",
            "fax_number": "419-636-6438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTFRIED",
        "first_name": "MCKENNA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28194377A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0036791",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007667A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "5693 YMCA Park Dr W",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468353280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "5693 YMCA Park Dr W",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468353280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgottfried122877@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "5693 YMCA Park Dr W",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468353280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sylvia Gossard
• Amanda Gossett, SLP
• Diane Louise Gotsch, RPH
• Gary Lynn Gotsch, D.D.S, M.S.D.
• Matthew Gotsch, DDS
• Jacob Samuel Gottlieb
• Wyatt Jeffry Gottschalk
• Saige Gottwald
• William D Goudy, D.O.
• Lindsay K Gough, NP

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.