Individual provider Active NPI

Marlene Kay Aldred, APRN, FNP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1366535692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
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

Updated by the provider on Jul 8, 2007

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330002581 MT Order and Referring Only - Nurse Practitioner 6800811191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
710002046AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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

Verify at the official NPI Registry.