Individual provider Active NPI

Karmen Wilson, NP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1689216442
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71009795A Issued in IN
Practice address
1721 Magnavox Way
Fort Wayne, IN 46804-1537
Phone
(260) 748-3650
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28202168A IN
Nurse Practitioner 363L00000X 71009795A IN Primary

Addresses

Primary practice location

1721 Magnavox Way
Fort Wayne, IN 46804-1537

Mailing address

1721 Magnavox Way
Fort Wayne, IN 46804-1537
Phone (260) 748-3650

Other practice location 1

10475 Crosspoint Blvd Ste 250
Indianapolis, IN 46256-3387
Phone (866) 949-0108

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
I20200311002348 IN Practitioner - Nurse Practitioner 4587092291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

7900 W Jefferson Blvd
Suite 202
Fort Wayne, IN 46804-4128
Phone (260) 435-4730

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28202168AINMDRegistered Nurse
71009795AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Jun 5, 2025 Accepting new patients
Lutheran Medical Group LLC Nurse Practitioner CurrentSince Jun 5, 2025 Accepting new patients
Global Wound Care Medical Group CurrentSince Sep 3, 2024 Accepting new patients

Locations

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

7900 W Jefferson Blvd
Ste 202
Fort Wayne, IN 46804
Phone (260) 424-9000

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

Interoperability endpoints

  • Direct secure messaging: ms_kwils232@landmarkhealth-direct.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1689216442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 MAGNAVOX WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041537",
            "telephone_number": "260-748-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 MAGNAVOX WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041537",
            "telephone_number": "260-748-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10475 Crosspoint Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462563387",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KARMEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28202168A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009795A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.