Individual provider Active NPI

Abigail Flack, NP

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1093587420
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014421A Issued in IN
Practice address
6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone
(260) 901-9601
NPI assigned
Oct 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71014421A IN Primary

Addresses

Primary practice location

6326 Constitution Dr
Fort Wayne, IN 46804-1518

Mailing address

6828 N 300 W
Roann, IN 46974-9669

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110001259 IN Practitioner - Nurse Practitioner 3375994734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RP Care LLCGroup PAC ID 9234424813, 31 clinicians

Practice addresses (Care Compare)

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

Hospital & facility affiliations

  • Dukes Memorial Hospital Hospital, Peru, IN, CCN 151318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71014421AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RP Care LLC Family CurrentSince Dec 15, 2023 Accepting new patients

Locations

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1093587420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6828 N 300 W",
            "city": "ROANN",
            "state": "IN",
            "postal_code": "469749669",
            "fax_number": "260-201-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-901-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACK",
        "first_name": "ABIGAIL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014421A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.