McKinzie Gale Edstene, PTA, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71018473A Issued in IN

Practice address

930 N 14TH St
New Castle, IN 47362-4311

Phone

(765) 521-2450

Fax

(765) 593-6001

NPI assigned

Jul 15, 2020

Last updated

Aug 6, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Kokomo, IN
  • NPI 1518069913
  NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD (past)

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1073121091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N 14TH ST",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473624311",
            "telephone_number": "765-521-2450",
            "fax_number": "765-593-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8905 Evergreen Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462402000",
            "country_code": "US",
            "telephone_number": "317-571-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDSTENE",
        "first_name": "MCKINZIE",
        "middle_name": "GALE",
        "credential": "PTA, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71018473A",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06005891A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dungarvin Indiana, LLC
• Dungarvin Indiana, LLC
• Austin Dynak
• Dawna East-McCoy, LHMC
• Rodolfo Echeverria, MD
• Tina Denise Eldridge-Ramseur, LMHC
• Embrace Hospice LLC
• Emgi - Henry, LLC
• Eye Center Group LLC (New Castle Eye Center South)
• Devin Farris

• Pediatric Nurse Practitioner in New Castle, IN
• Providers in New Castle, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• 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.

Verify at the official NPI Registry.