Individual provider Active NPI

Kelsey A Harner, FNP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1306498241
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009125A Issued in IN
Practice address
4020 New Vision Dr
Fort Wayne, IN 46845-1737
Phone
(260) 423-2567
Fax
(260) 420-2415
NPI assigned
Jul 11, 2019
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 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 71009125A IN Primary

Addresses

Primary practice location

4020 New Vision Dr
Fort Wayne, IN 46845-1737

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

2246 N Pointe Dr
Warsaw, IN 46582-9042
Phone (574) 349-9242

Other names 1

  • Kelsey A Richard Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Kelsey.Richard@forefrontdermatology.emadirect.md
Direct Messaging Address Kelsey.Richard@forefrontdermatology.emadirect.md

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
I20190814000492 IN Practitioner - Nurse Practitioner 2466789433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

2246 N Pointe Dr
Warsaw, IN 46582-9042
Phone (574) 349-9242

303 S Walnut St
Seymour, IN 47274-2368
Phone (812) 358-7705

4020 New Vision Dr
Fort Wayne, IN 46845-1737
Phone (260) 423-2567

7516 Eagle Crest Blvd
Suite D
Evansville, IN 47715-9142
Phone (812) 401-8999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71009125AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Feb 1, 2021 Accepting new patients
Lutheran Medical Group LLC CurrentSince Sep 1, 2019 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Feb 1, 2021 Accepting new patients
Lutheran Medical Group LLC CurrentSince Sep 1, 2019 Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients

Locations

7516 Eagle Crest Blvd
Ste D
Evansville, IN 47715
Phone (812) 401-8999

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

4020 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 423-2567

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

7910 W Jefferson Blvd
Ste 120
Fort Wayne, IN 46804
Phone (260) 435-7612

7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298

8325 S Emerson Ave
Ste C1
Indianapolis, IN 46237
Phone (317) 780-7400

303 S Walnut St
Seymour, IN 47274
Phone (812) 358-7705

2246 N Pointe Dr
Warsaw, IN 46582
Phone (574) 349-9242

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Organizations & group practices 5

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

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1306498241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451737",
            "telephone_number": "260-423-2567",
            "fax_number": "260-420-2415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2246 N Pointe Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465829042",
            "country_code": "US",
            "telephone_number": "574-349-9242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARNER",
        "first_name": "KELSEY",
        "middle_name": "A",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009125A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelsey.Richard@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2246 N Pointe Dr",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465829042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelsey.Richard@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "4020 New Vision Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "RICHARD",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.