Active NPI
Pamela Thornton, PMHNP-BC
- Nurse Practitioner
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71008077A
- Practice address
- 1717 S Calhoun St
Fort Wayne, IN 46802-5257 - Phone
- (260) 458-2641
- NPI assigned
- Jun 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71008077A | IN | |
| Nurse Practitioner | 363L00000X | 71008077A | IN | Primary |
Addresses
Primary practice location
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Mailing address
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Phone (260) 458-2641
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1717 S Calhoun St
Fort Wayne, IN 46802-5257
1721 S Calhoun St
Neighborhood Health Clinics Inc
Fort Wayne, IN 46802-5257
Phone (260) 458-2641
750 Broadway
Suite 350
Fort Wayne, IN 46802-1412
Phone (260) 423-6621
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71008077A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bowen Health Inc | Current | Accepting new patients | |
| Neighborhood Health Clinics, Inc | Current | Accepting new patients | |
| Neighborhood Health Clinics, Inc | Current | Accepting new patients | |
| Park Center Inc | Current | Accepting new patients | |
| Bowen Health Inc | Current | Accepting new patients | |
| Park Center Inc | Current | Accepting new patients |
Locations
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
1909 Carew St
Fort Wayne, IN 46805
Phone (260) 481-2800
909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718
1721 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2571
1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641
850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169
2219 Dubois Dr
Warsaw, IN 46580
Phone (574) 269-3420
2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573
Interoperability endpoints
- pamela.thornton@nhci.eclinicaldirectplus.com
Organizations & group practices 6
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.
-
- Clinic/Center
- Fort Wayne, IN
- NPI 1548291222
-
dba Otis R Bowen Center
- Adult Mental Health Clinic/Center
- Warsaw, IN
- NPI 1639172810
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fort Wayne, IN
- NPI 1306897004
-
- Federally Qualified Health Center (FQHC)
- Fort Wayne, IN
- NPI 1023668183
-
- Clinic/Center
- Fort Wayne, IN
- NPI 1730989518
-
- Psychiatric Hospital
- Fort Wayne, IN
- NPI 1457772402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1609361062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 S CALHOUN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468025257",
"telephone_number": "260-458-2641",
"fax_number": "260-458-3093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S CALHOUN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468025257",
"telephone_number": "260-458-2641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORNTON",
"first_name": "PAMELA",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-28",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IN",
"license": "71008077A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71008077A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.