Individual provider Active NPI

Irene T Hoover, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1639103153
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71001646A Issued in IN
Practice address
2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone
(260) 344-4035
Fax
(260) 969-9272
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71001646A IN Primary

Addresses

Primary practice location

2200 Randallia Dr
Fort Wayne, IN 46805-4638

Mailing address

6435 W Jefferson Blvd PMB 109
Fort Wayne, IN 46804-6203
Phone (260) 344-4035

Other identifiers 1

IdentifierTypeStateIssuer
200511080MedicaidIN

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
I20040611001290 IN Practitioner - Nurse Practitioner 2860475514 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Current Accepting new patients
Hospital Care Group, P.C. CurrentSince Aug 1, 2018 Accepting new patients
Park Center Inc CurrentSince Jun 28, 2023 Accepting new patients
Parkview Health System, Inc. Psychiatric/Mental Health CurrentSince Jun 28, 2023 Accepting new patients
Park Center Inc CurrentSince Jun 28, 2023 Accepting new patients
FWBH, LLC CurrentSince May 1, 2023 Accepting new patients
South Bend Psychiatry LLC PastSince Nov 1, 2009 Accepting new patients

Locations

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

3955 W Washington Center Rd
#R
Fort Wayne, IN 46818

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

3955 W Washington Center Rd
Fort Wayne, IN 46818
Phone (260) 800-3601

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: ihoover286951@direct.parkviewexchange.com

Organizations & group practices 7

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1639103153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 W JEFFERSON BLVD PMB 109",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046203",
            "telephone_number": "260-344-4035",
            "fax_number": "260-969-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054638",
            "telephone_number": "260-344-4035",
            "fax_number": "260-969-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "IRENE",
        "middle_name": "T",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71001646A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200511080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.