Individual provider Active NPI

Regina M Frederick, NP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1447731302
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71008494A Issued in IN
Practice address
11143 Parkview Plaza Dr Ste 200
Fort Wayne, IN 46845-1728
Phone
(260) 266-8820
Fax
(260) 266-8829
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71008494A IN Primary

Addresses

Primary practice location

11143 Parkview Plaza Dr Ste 200
Fort Wayne, IN 46845-1728

Mailing address

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

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rfrederick194221@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
I20181217003007 IN Practitioner - Nurse Practitioner 6305181553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

3816 New Vision Dr
PPG Physical Medicine and Rehab
Fort Wayne, IN 46845-1708
Phone (260) 469-6637

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71008494AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince Mar 11, 2024 Accepting new patients
Meridian Health Services Corp CurrentSince Mar 11, 2024 Accepting new patients
Parkview Health System, Inc. Nurse Practitioner CurrentSince Dec 7, 2018 Accepting new patients
Parkview Health System Inc Nurse Practitioner Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

303 S Main St
Ste 300
Bluffton, IN 46714
Phone (260) 919-3300

11143 Parkview Plaza Dr
Ste 200
Fort Wayne, IN 46845
Phone (260) 266-7400

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

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

1234 E DuPont Rd
Ste 5
Fort Wayne, IN 46825
Phone (260) 266-2800

3816 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 266-8210

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

240 N Tillotson Ave
Muncie, IN 47304

Interoperability endpoints

  • Direct secure messaging: rfrederick194221@direct.parkviewexchange.com

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 6

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1447731302",
    "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": "11143 PARKVIEW PLAZA DR STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451728",
            "telephone_number": "260-266-8820",
            "fax_number": "260-266-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "REGINA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71008494A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfrederick194221@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11143 Parkview Plaza Dr Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451728",
            "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": "11143 Parkview Plaza Dr Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451728",
            "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": "11143 Parkview Plaza Dr Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451728",
            "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.