Mary Casey Christophersen, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71011222A Issued in IN

Practice address

6507 E State Blvd
Fort Wayne, IN 46815-7026

Phone

(260) 486-3300

Fax

(260) 486-3600

NPI assigned

Jan 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Casey Niezer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Fort Wayne Pediatrics, PC

  • Pediatrics Physician
  • Fort Wayne, IN
  • NPI 1063595536
  NPD (past)

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1669061289",
    "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": "6507 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157026",
            "telephone_number": "260-486-3300",
            "fax_number": "260-486-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHERSEN",
        "first_name": "MARY",
        "middle_name": "CASEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28234514A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71011222A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "NIEZER",
            "middle_name": "CASEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelley Christoffel
• Cori L Christoffersen, RN
• Christopher L Bible, DDS, PC (Comfort Dental)
• Sarah Beth Christopher, DPT
• Jonathan Christophersen, CRNA
• Dennis John Chubinski, D.P.M.
• Chuck Howie Counseling Services, PC
• Chuck's Foot Support
• Catherine S. Chung, M.D.
• Ann Chupp

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.