NPIMap

Organization Active NPI

Essential Lab

  • Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1063178127
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ESSENTIAL LAB
Practice address
6324 Constitution Dr
Fort Wayne, IN 46804-1518
Phone
(260) 467-9837
NPI assigned
Nov 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Authorized official

Name
Sedricka Epperson, MSN, RNNPI 1952101925
Title
Ceo
Phone
(260) 467-9837

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
Public Health or Welfare Agency 251K00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6324 Constitution Dr
Fort Wayne, IN 46804-1518

Mailing address

6324 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 467-9837

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1063178127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6324 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-467-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-467-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "EPPERSON",
        "authorized_official_first_name": "SEDRICKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-467-9837",
        "authorized_official_credential": "MSN, RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.