Individual provider Active NPI

Samantha R Wilkinson, NP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1710426176
Registry record updated Aug 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006896A Issued in IN
Practice address
2720 Dupont Commerce CT
Fort Wayne, IN 46825-2394
Phone
(260) 484-7622
NPI assigned
Feb 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006896B IN
Family Nurse Practitioner 363LF0000X 71006896A IN Primary

Addresses

Primary practice location

2720 Dupont Commerce CT
Fort Wayne, IN 46825-2394

Mailing address

23435 Woodburn Rd
Woodburn, IN 46797-9740
Phone (260) 414-1855

Other names 1

  • Samantha R Bergman Former name

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
I20170307001335 IN Practitioner - Nurse Practitioner 6305120551 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians
Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

150 W Market St
Suite 400
Indianapolis, IN 46204-2810
Phone (855) 743-2247

8398 Mississippi St
FL 2
Merrillville, IN 46410-6316
Phone (855) 743-2247

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006896AINMDFamily Nurse Practitioner
71006896BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Extended Care Specialists, Inc Family CurrentSince Sep 1, 2025 Accepting new patients
Eventus Wholehealth Midwest Inc CurrentSince Nov 11, 2025 Accepting new patients
Eventus Ecs, Inc CurrentSince Sep 1, 2025 Accepting new patients
Heartland Hospice Services LLC PastSince Aug 17, 2025 Accepting new patients

Locations

2100 Midway St
Columbus, IN 47201
Phone 3178181240225

3512 Stellhorn Rd
Fort Wayne, IN 46815

150 W Market St
Ste 400
Indianapolis, IN 46204

8398 Mississippi St
Fl 2
Merrillville, IN 46410

Organizations & group practices 4

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": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755302400000",
    "number": "1710426176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23435 WOODBURN RD",
            "city": "WOODBURN",
            "state": "IN",
            "postal_code": "467979740",
            "telephone_number": "260-414-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 DUPONT COMMERCE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252394",
            "telephone_number": "260-484-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "SAMANTHA",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2025-08-16",
        "certification_date": "2025-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006896B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006896A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BERGMAN",
            "middle_name": "R",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.