Ellen Catherine Fagan-Pryor, MSN, PMHCNS, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

28101257A Issued in IN

Practice address

2121 Lake Avene
Fort Wayne, IN 46805-5100

Phone

(260) 445-2123

NPI assigned

Sep 14, 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

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

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1508961236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8818 HOFFMAN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468169595",
            "telephone_number": "260-639-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVENE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-445-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN-PRYOR",
        "first_name": "ELLEN",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MSN, PMHCNS, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "IN",
            "license": "28101257A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Osita Victor Ezeakudo, M.D.
• Patricia Oghogho Ezeakudo
• Fab Mental Health Counseling LLC
• Jessica Fabian
• Jean M Fabini, NP
• Benny Fair Jr., D.P.M.
• Alyssa B Fairbanks, PTA
• Joshua Fairbanks
• Shah Faisal
• John M Falatko

• Adult Psychiatric/Mental Health Registered Nurse in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.