Anne G W Harless, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71006721A Issued in IN

Practice address

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Phone

(260) 483-9081

Fax

(260) 483-9196

NPI assigned

Oct 12, 2016

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

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Beewell Healthcare LLC

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1023876877
  Medicare reassignment

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1174073373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 PEARL ST",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460641232"
        },
        {
            "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",
            "fax_number": "260-483-9196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 Pearl St",
            "address_purpose": "LOCATION",
            "city": "Pendleton",
            "state": "IN",
            "postal_code": "460641232",
            "country_code": "US",
            "telephone_number": "317-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARLESS",
        "first_name": "ANNE",
        "middle_name": "G W",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IN",
            "license": "71006721A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71006721A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201405200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01751331",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Edward Harkenrider, DC
• Mallory Harker
• Sandra L Harlan, O.T.
• Sarah Harlan
• Zachary Harlan
• Teresa Suzanne Harless
• Jon T Harman, M.D.
• Amy Marie Harmeyer, FNP-BC
• Lauren Harmison, FNP
• Courtney Harmon, PHARMD

• Gerontology Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.