Individual provider Active NPI

Pamela Ann Terwilleger, RN

  • Gastroenterology Registered Nurse
  • Fort Wayne, IN
National Provider Identifier
1083588586
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology Registered NurseTaxonomy code 163WG0100X
License
28225630A Issued in IN
Practice address
2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone
(260) 373-4000
Fax
(260) 373-3348
NPI assigned
Sep 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X 28225630A IN Primary

Addresses

Primary practice location

2200 Randallia Dr
Fort Wayne, IN 46805-4638

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Phone (260) 433-4822

Other practice location 1

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 266-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28225630AINMDGastroenterology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1759190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1083588586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-433-4822",
            "fax_number": "260-373-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054638",
            "telephone_number": "260-373-4000",
            "fax_number": "260-373-3348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11109 Parkview Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451701",
            "country_code": "US",
            "telephone_number": "260-266-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERWILLEGER",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-30",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "IN",
            "license": "28225630A",
            "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 Oct 24, 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.