Elizabeth A Adams, NP
Individual provider Active NPI Gerontology Nurse Practitioner · Fort Wayne, IN
NPI 1164847372 · NPPES record last updated Aug 30, 2024
Key facts
- NPI
- 1164847372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 71009495A (IN)
- Practice address
- 3512 Stellhorn Rd
Fort Wayne, IN 46815-4631 - Phone
- (260) 483-9081
- NPI assigned
- Feb 25, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Eventus Ecs, Inc
Extended Care Specialists, Inc
Practice addresses (Care Compare)
150 W Market St
Suite 400
Indianapolis, IN 46204-2810
Phone (855) 743-2247
8398 Mississippi St
FL 2
Merrillville, IN 46410-6316
Phone (855) 743-2247
Hospital & facility affiliations
- Johnson Memorial Hospital
- Reid Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN, OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191115001363 | IN | Practitioner - Nurse Practitioner | 8729393160 | Reassigns benefits to 8 organizations |
| I20220920002722 | OH | Practitioner - Nurse Practitioner | 8729393160 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17556 | OH | MD | Prosthodontist |
| 28184531A | IN | MD | Registered Nurse |
| 2290922 | MA | MD | Critical Care Medicine Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Extended Care Specialists, Inc | Current |
Accepting new patients | |
| University Family Physicians, Inc. | Current |
Accepting new patients | |
| My Mobile MD LLC | Current |
Accepting new patients | |
| Mercy Health Physicians Lima Specialty Care LLC | Current |
Accepting new patients | |
| Eventus Wholehealth Midwest Inc | Current |
Accepting new patients | |
| University Surgeons, Inc. | Current |
Accepting new patients | |
| Eventus WH Midwest Care, LLC | Current |
Accepting new patients | |
| University Family Physicians, Inc. | Current |
Accepting new patients | |
| Eventus Ecs - Kentucky, PLLC | Current |
Accepting new patients | |
| Eventus Ecs, Inc | Current |
Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients |
Locations
7216 Solutions Ctr
Chicago, IL 60677
7630 Solutions Ctr
Chicago, IL 60677
2100 Midway St
Ste 3722
Columbus, IN 47201
2100 Midway St
Columbus, IN 47201
Phone 3178181240225
3512 Stellhorn Rd
Fort Wayne, IN 46815
1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857
3815 River Crossing Pkwy
Ste 100
Indianapolis, IN 46240
Phone (317) 218-3479
150 W Market St
Ste 400
Indianapolis, IN 46204
550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
1400 N Ritter Ave
Ste 220
Indianapolis, IN 46219
Phone (317) 355-1555
429 E Vermont St
Ste 110
Indianapolis, IN 46202
Phone (317) 536-2290
8398 Mississippi St
Fl 2
Merrillville, IN 46410
830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960
770 W High St
Ste 160
Lima, OH 45801
Phone (419) 996-5224
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28184531A | IN | |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 17556 | OH | |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 2290922 | MA | |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 4704327849 | MI | |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 71009495A | IN | |
| Gerontology Nurse Practitioner | 363LG0600X | 71009495A | IN | Yes |
Addresses
Primary practice location
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Mailing address
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone (260) 483-9081
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300032627 | Medicaid | IN |
Other providers in Fort Wayne, IN
- Adams County Memorial Hospital
- Adams County Memorial Hospital
- Susan M Adams-Hayes
- Abigail Adams
- Brian A. Adams
- Grace A. Adams
- Grant Adams
- Judy A Adams
- Kathleen Adams
- Malin Suzan Adams
All providers in Fort Wayne, IN · Gerontology Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.