Shannon L Decker
Individual provider Active NPI Nurse Practitioner · Fort Wayne, IN
NPI 1003469925 · NPPES record last updated Mar 14, 2024
Key facts
- NPI
- 1003469925
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71009255A (IN)
- Practice address
- 11108 Parkview Circle Dr
Fort Wayne, IN 46845-1730 - Phone
- (260) 266-5700
- Fax
- (260) 266-5910
- NPI assigned
- Jul 19, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Parkview Health System Inc
Practice addresses (Care Compare)
11108 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone (260) 266-5700
Hospital & facility affiliations
- Parkview Regional Medical Center
- Parkview Whitley Hospital
- Community Hospitals and Wellness Centers
- Parkview Dekalb Hospital
- Parkview Noble Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.53 of 100
- Quality
- 70
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191009001616 | IN | Practitioner - Nurse Practitioner | 7517298326 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28202903A | IN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Nurse Practitioner | Current | Accepting new patients |
| Parkview Health System, Inc. | Nurse Practitioner | Current |
Accepting new patients |
Locations
3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
11108 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (260) 266-4480
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
401 N Sawyer Rd
Kendallville, IN 46755
Phone (260) 347-1100
Interoperability endpoints
- sdecker225877@direct.parkviewexchange.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28202903A | IN | |
| Nurse Practitioner | 363L00000X | 71009255A | IN | Yes |
Addresses
Primary practice location
11108 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sdecker225877@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ |
Other providers in Fort Wayne, IN
- Georges Debal
- Joellen Decamp
- Joseph Richard Decamp
- Mackenzie Dechand
- Kyle James Deck
- Jenna Lynn Decraene
- Bradley David Dedic
- Alyson Deel
- Coral Deermer
- Erica Deetz
All providers in Fort Wayne, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.