Active NPI
Erin Elise Peer, NP-C
- Nurse Practitioner
- Fort Wayne, IN
National Provider Identifier
1053795096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71005562A
- Practice address
- 3534 Brooklyn Ave
Fort Wayne, IN 46809-1361 - Phone
- (260) 478-5130
- NPI assigned
- Jul 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71005562A | IN | Primary |
Addresses
Primary practice location
3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Mailing address
3534 Brooklyn Ave
Fort Wayne, IN 46809-1361
Phone (260) 478-5130
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100465770 | Medicaid | IN | |
| 71005562A | Other | IN | APN LICENSE |
| 71005562B | Other | IN | CSR LICENSE |
| 01043132 | Other | IN | STATE LICENSE FOR JEFFERSON PEDIATRICS |
Other names 1
- Erin Keim
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190625002469 | IN | Practitioner - Nurse Practitioner | 7719211705 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71005562A | IN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1053795096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3534 BROOKLYN AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468091361",
"telephone_number": "260-478-5130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3534 BROOKLYN AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468091361",
"telephone_number": "260-478-5130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEER",
"first_name": "ERIN",
"middle_name": "ELISE",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-18",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71005562A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100465770",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APN LICENSE",
"identifier": "71005562A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSR LICENSE",
"identifier": "71005562B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE FOR JEFFERSON PEDIATRICS",
"identifier": "01043132",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ERIN",
"last_name": "KEIM",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.