Individual provider Active NPI

Allissa Marie Walker, FNP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1194593491
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014683A Issued in IN
Practice address
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 969-7216
Fax
(260) 969-7230
NPI assigned
Dec 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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 71014683A IN Primary

Addresses

Primary practice location

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

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
I20240123002433 IN Practitioner - Nurse Practitioner 5698127892 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71014683AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Jan 16, 2024 Accepting new patients
Lutheran Medical Group LLC CurrentSince Jan 16, 2024 Accepting new patients

Locations

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

Organizations & group practices 2

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": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1194593491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-969-7216",
            "fax_number": "260-969-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ALLISSA",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-15",
        "last_updated": "2024-07-11",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014683A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.