Marlise Fletter, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71000262A Issued in IN

Practice address

10620 Corporate Dr Ste a
Fort Wayne, IN 46845-1711

Phone

(260) 423-2567

Fax

(260) 420-2415

NPI assigned

Apr 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

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.

• St Joseph Medical Group Inc

  • Family Medicine Physician
  • Angola, IN
  • NPI 1801851902

  Nurse Practitioner

  NPD (past)
• St Joseph Medical Group Inc

  • General Practice Physician
  • Fort Wayne, IN
  • NPI 1811952070

  Nurse Practitioner

  NPD (past)
• Gary R Kutsikovich MD and Associates Inc

  • Neurology Physician
  • Mentor, OH
  • NPI 1841250420
  NPD (past)

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1467418079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 CORPORATE DR STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451711",
            "telephone_number": "260-423-2567",
            "fax_number": "260-420-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 CORPORATE DR STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451711",
            "telephone_number": "260-423-2567",
            "fax_number": "260-420-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETTER",
        "first_name": "MARLISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000262A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200273770A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Flaugh
• Brittany Nicole Fleckenstein, OTR
• Demetria Lynette Fleming, ATC
• Brian K Flesch, MSW, LCSW
• Jillian Fletcher
• Matthew Brooks Flinn
• Michael Joseph Fliotsos, MD
• Julie M Flohr, LMHC
• Stacie Flood, MSW
• Tyson Rae Flora, MA LMHC

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.

Verify at the official NPI Registry.