Individual provider Active NPI

Jessica Ford, NP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1427619212
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28197613A Issued in IN
Practice address
3707 New Vision Dr
Fort Wayne, IN 46845-1702
Phone
(260) 484-0850
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 28197613A IN Primary

Addresses

Primary practice location

3707 New Vision Dr
Fort Wayne, IN 46845-1702

Mailing address

620 W Edison Rd Ste 1110
Mishawaka, IN 46545-2784
Phone (574) 258-1110

Other practice location 1

600 East Blvd
Elkhart, IN 46514-2483
Phone (574) 523-2483

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
I20190723000496 IN Practitioner - Nurse Practitioner 6305172867 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
Fort Wayne Radiology Associates LLCGroup PAC ID 5294624060, 35 clinicians

Practice addresses (Care Compare)

3707 New Vision Dr
Fort Wayne, IN 46845-1702
Phone (260) 969-1124

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.28 of 100Reported as group
Quality
77.29
Improvement activities
40
Cost
73.88

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Radiology Associates LLC CurrentSince Aug 1, 2022 Accepting new patients
Breast Diagnostic Center, LLC CurrentSince Aug 1, 2022 Accepting new patients
P E T Imaging Services LLC Past Accepting new patients

Locations

3707 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-4000

2110 Carew St
Fort Wayne, IN 46805
Phone (219) 432-6710

1818 Carew St
Ste 30
Fort Wayne, IN 46805
Phone (260) 425-5900

Organizations & group practices 3

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.

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1427619212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W EDISON RD STE 1110",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465452784",
            "telephone_number": "574-258-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "260-484-0850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 East Blvd",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142483",
            "country_code": "US",
            "telephone_number": "574-523-2483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "JESSICA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28197613A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.