Active NPI
Marlene Kay Aldred, APRN, FNP-C
- Family Nurse Practitioner
- Fort Wayne, IN
National Provider Identifier
1366535692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Practice address
- 7205 Pumpkin LN
Fort Wayne, IN 46835-9552 - Phone
- (260) 740-2859
- NPI assigned
- Sep 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | IN | Primary |
Addresses
Primary practice location
7205 Pumpkin LN
Fort Wayne, IN 46835-9552
Mailing address
7205 Pumpkin LN
Fort Wayne, IN 46835-9552
Phone (260) 740-2859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160330002581 | MT | Order and Referring Only - Nurse Practitioner | 6800811191 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 710002046A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Extended Care Specialists, Inc | Family | Past | Accepting new patients |
Organizations & group practices 1
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": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366535692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7205 PUMPKIN LN",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468359552",
"telephone_number": "260-740-2859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7205 PUMPKIN LN",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468359552",
"telephone_number": "260-740-2859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALDRED",
"first_name": "MARLENE",
"middle_name": "KAY",
"credential": "APRN, FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.