Kelley Christoffel

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71015918A Issued in IN

Practice address

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604

Phone

(260) 426-8117

NPI assigned

Oct 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Nose and Throat Associates PCGroup PAC ID 3375504301, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Parkview Noble Hospital Hospital, Kendallville, IN, CCN 150146
• Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Ear, Nose & Throat Associates, PC

  • Otolaryngology Physician
  • Fort Wayne, IN
  • NPI 1851377691
  Medicare reassignment Care Compare group NPD
• The Hearing Center LLC

  • Audiologist
  • Fort Wayne, IN
  • NPI 1891771655
  NPD (past)

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

• Adams County Memorial Hospital

  • Critical Access Hospital
  • Decatur, IN
  • NPI 1689696148
  Care Compare affiliation
• Community Hospital of Noble County, Inc.

  • General Acute Care Hospital
  • Kendallville, IN
  • NPI 1457366189
  Care Compare affiliation
• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1043031693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12825 CRYSTAL CREEK PKWY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468452360",
            "telephone_number": "260-316-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOFFEL",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015918A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jilian Christlieb
• Christman Consulting, LLC
• Chad Steven Christman, D.O.
• Jesse Christman, PHARMD
• Kristen Elizabeth Christman, PHARMD
• Cori L Christoffersen, RN
• Christopher L Bible, DDS, PC
• Sarah Beth Christopher, DPT
• Jonathan Christophersen, CRNA
• Mary Casey Christophersen, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.