Individual provider Active NPI

Jennifer Ann Burkhart, P.A.

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1417343047
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001328A Issued in IN
Practice address
1818 Carew St Ste 320
Fort Wayne, IN 46805-4764
Phone
(260) 373-5890
Fax
(260) 422-8444
NPI assigned
Apr 10, 2015
Last updated
Oct 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001328A IN Primary

Addresses

Primary practice location

1818 Carew St Ste 320
Fort Wayne, IN 46805-4764

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jburkhart86795@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

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
I20150504001040 IN Practitioner - Physician Assistant 5991024507 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc CurrentSince Aug 1, 2016 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

Interoperability endpoints

  • Direct secure messaging: jburkhart86795@direct.parkviewexchange.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1417343047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 CAREW ST STE 320",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054764",
            "telephone_number": "260-373-5890",
            "fax_number": "260-422-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001328A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jburkhart86795@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1818 Carew St Ste 320",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1818 Carew St Ste 320",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1818 Carew St Ste 320",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.