Individual provider Active NPI

Jodi Lynn Guy, FNP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1104411875
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014120A Issued in IN
Practice address
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone
(260) 483-9081
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP001980 SD
Family Nurse Practitioner 363LF0000X 71014120A IN Primary

Addresses

Primary practice location

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Mailing address

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone (919) 932-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, NC, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230804002241 IN Practitioner - Nurse Practitioner 7214345289 Reassigns benefits to 5 organizations
I20240916001271 NC Practitioner - Nurse Practitioner 7214345289 Reassigns benefits to 1 organization
I20240926002414 OH Practitioner - Nurse Practitioner 7214345289 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
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians
Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians

Practice addresses (Care Compare)

1010 N Main St
Bluffton, IN 46714-1321
Phone (260) 261-1385

150 W Market St
Suite 400
Indianapolis, IN 46204-2810
Phone (855) 743-2247

2008 N Walnut St
Hartford City, IN 47348-1364
Phone (765) 329-6662

3719 S Western Ave
Marion, IN 46953-4828
Phone (765) 293-8485

4152 W State Rd
Hanover, IN 47243-9070
Phone (901) 351-1791

4400 Easton CMNS
Suite 125
Columbus, OH 43219-6223
Phone (855) 743-2247

980 N Meridian St
Portland, IN 47371-1129
Phone (260) 703-3312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71014120AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
FC Indiana, LLC CurrentSince Nov 1, 2024 Accepting new patients
FC Indiana, LLC CurrentSince Nov 1, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 1, 2024 Accepting new patients
Eventus Wholehealth Aco LLC CurrentSince Aug 1, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

2418 16th St
Bedford, IN 47421
Phone (812) 278-3154

1159 W Jefferson St
Ste 204
Franklin, IN 46131

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1104411875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154631",
            "telephone_number": "919-932-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154631",
            "telephone_number": "260-483-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUY",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001980",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014120A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.