Individual provider Active NPI

Christopher A Fegley, PA

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1003814476
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003719A Issued in IN
Practice address
7910 W Jefferson Blvd Ste 102
Fort Wayne, IN 46804-4159
Phone
(260) 458-3555
Fax
(260) 458-3530
NPI assigned
Jul 11, 2005
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003719A IN Primary

Addresses

Primary practice location

7910 W Jefferson Blvd Ste 102
Fort Wayne, IN 46804-4159

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Other identifiers 1

IdentifierTypeStateIssuer
970019087OtherOHMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christopher.fegley@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20080430000873 MI Practitioner - Physician Assistant 0648224352 Reassigns benefits to 1 organization
I20221108000266 IN Practitioner - Physician Assistant 0648224352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 425-6030

11115 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 672-6443

2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297

7938 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 436-8583

7950 W Jefferson Blvd
Lutheran Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

7952 W Jefferson Blvd
The Orthopedic Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-2999

7956 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2836

7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-6105

7988 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 969-7280

817 Trail Ridge Rd
Albion, IN 46701-1534
Phone (260) 373-9590

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003719AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC Physician Assistant CurrentSince Oct 25, 2022 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Mar 25, 2008 Accepting new patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Mar 25, 2008 Accepting new patients
Lutheran Medical Group LLC CurrentSince Oct 25, 2022 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Parkview Health System Inc CurrentSince Oct 8, 2023 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

7910 W Jefferson Blvd
Ste 102
Fort Wayne, IN 46804
Phone (260) 436-2424

1100 E Michigan Ave
Ste 301
Jackson, MI 49201
Phone (517) 817-7605

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: cfegley571685@direct.parkviewexchange.com
  • Direct secure messaging: christopher.fegley@lutheranhealthnetwork.cernerdirect.com

Organizations & group practices 7

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1003814476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-458-3555",
            "fax_number": "260-458-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEGLEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003719A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "970019087",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopher.fegley@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "7910 W Jefferson Blvd Ste 102",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.