Wonda Fay Elmore

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71002916B Issued in IN

Practice address

255 N Miami St
Wabash, IN 46992-2705

Phone

(574) 385-3145

Fax

(260) 563-1902

NPI assigned

May 27, 2009

Last updated

Feb 14, 2024By the provider in NPPES

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

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bowen Health Inc

  dba Otis R Bowen Center

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810
  Medicare reassignment NPD
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1053546556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N MIAMI ST",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469922705",
            "telephone_number": "574-385-3145",
            "fax_number": "260-563-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N MIAMI ST",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469922705",
            "telephone_number": "574-385-3145",
            "fax_number": "260-563-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "WONDA",
        "middle_name": "FAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002916B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300002655",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001090820",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janell L Dockter
• Emily Marie Dotson, MA
• Kathryn Douglass, RN
• Elizabeth Nicole Dyson, BSW
• Todd J. Elliott, D.C.
• Jessica Engels
• Nicole R Enslen
• Family Chiropractic PC
• Family Physicians Associated
• Farlow Enterprises, Inc.

• Family Nurse Practitioner in Wabash, IN
• Providers in Wabash, 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 Feb 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.