Individual provider Active NPI

Sonya Rocquil Dubose, NURSE PRACTITIONER

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1619681871
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71013580A Issued in IN
Practice address
11108 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone
(260) 266-5700
Fax
(260) 266-5910
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiac Rehabilitation Registered Nurse 163WC3500X 28140329A IN
Nurse Practitioner 363L00000X 71013580A IN Primary

Addresses

Primary practice location

11108 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Mailing address

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

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sdubose524559@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
I20230801000577 IN Practitioner - Nurse Practitioner 6901267418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
28140329AINMDCardiac Rehabilitation Registered Nurse
71013580AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System, Inc. Nurse Practitioner CurrentSince Jun 11, 2023 Accepting new patients
Parkview Health System Inc Nurse Practitioner CurrentSince Mar 19, 2023 Accepting new patients
Fort Wayne Cardiology Corporation PastSince Mar 19, 2023 Accepting new patients

Locations

11108 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-8900

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

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

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

401 N Sawyer Rd
Kendallville, IN 46755
Phone (260) 347-1100

Interoperability endpoints

  • Direct secure messaging: sdubose524559@direct.parkviewexchange.com

Organizations & group practices 3

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1619681871",
    "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": "11108 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-266-5700",
            "fax_number": "260-266-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "SONYA",
        "middle_name": "ROCQUIL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC3500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": "IN",
            "license": "28140329A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71013580A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdubose524559@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11108 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "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": "11108 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "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": "11108 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "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.