Individual provider Active NPI

Pamela Thornton, PMHNP-BC

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1609361062
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71008077A Issued in IN
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

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806001757 IN Practitioner - Nurse Practitioner 2567710619 Reassigns benefits to 3 organizations

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
Neighborhood Health Clinics IncGroup PAC ID 8022926294, 18 clinicians

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

LicenseStateTypeSpecialty
71008077AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc CurrentSince Aug 15, 2022 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince Jul 15, 2024 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince Jul 15, 2024 Accepting new patients
Park Center Inc CurrentSince Dec 15, 2019 Accepting new patients
Bowen Health Inc CurrentSince Aug 15, 2022 Accepting new patients
Park Center Inc CurrentSince Dec 15, 2019 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.