Individual provider Active NPI

Amber Wagley

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1699407668
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71012754A Issued in IN
Practice address
1818 Carew St Ste 120
Fort Wayne, IN 46805-4764
Phone
(260) 425-6200
Fax
(260) 425-6205
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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 28236162A IN
Nurse Practitioner 363L00000X 71012754A IN Primary

Addresses

Primary practice location

1818 Carew St Ste 120
Fort Wayne, IN 46805-4764

Mailing address

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

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address awagley503159@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
I20220811003695 IN Practitioner - Nurse Practitioner 1153704929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

1818 Carew St
Fort Wayne, IN 46805-4764

817 Trail Ridge Rd
Albion, IN 46701-1534
Phone (260) 373-9590

Hospital & facility affiliations

  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

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
28236162AINMDRegistered Nurse
71012754AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Nurse Practitioner CurrentSince Sep 9, 2022 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

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

1818 Carew St
Ste 120
Fort Wayne, IN 46805
Phone (260) 373-8190

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

Interoperability endpoints

  • Direct secure messaging: awagley503159@direct.parkviewexchange.com

Organizations & group practices 1

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1699407668",
    "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": "1818 CAREW ST STE 120",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054764",
            "telephone_number": "260-425-6200",
            "fax_number": "260-425-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGLEY",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28236162A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012754A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awagley503159@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1818 Carew St Ste 120",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054764",
            "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": "1818 Carew St Ste 120",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054764",
            "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": "1818 Carew St Ste 120",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054764",
            "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.