Individual provider Active NPI

Mallori Zechiel, FNP-C

  • Primary Care Nurse Practitioner
  • Warsaw, IN
National Provider Identifier
1740137033
Registry record updated Mar 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
71017866A Issued in IN
Practice address
902 Provident Dr Ste C
Warsaw, IN 46580-3379
Phone
(574) 269-8338
NPI assigned
Mar 14, 2026
Last updated
Mar 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 71017866A IN Primary

Addresses

Primary practice location

902 Provident Dr Ste C
Warsaw, IN 46580-3379

Mailing address

11750 20B Rd
Argos, IN 46501-9761

Other practice location 1

2101 DuBois Dr
Warsaw, IN 46580-3210
Phone (574) 267-3200

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
I20260327001939 IN Practitioner - Nurse Practitioner 5193200194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6920 Pointe Inverness Way
Suite 200
Fort Wayne, IN 46804-7934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71017866AINMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kosciusko Medical Group LLC CurrentSince Apr 1, 2026 Accepting new patients
Lutheran Medical Group LLC PastSince Apr 1, 2026 Accepting new patients

Locations

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

902 Provident Dr
Ste A
Warsaw, IN 46580
Phone (574) 269-8338

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1773446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1740137033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 20B RD",
            "city": "ARGOS",
            "state": "IN",
            "postal_code": "465019761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 PROVIDENT DR STE C",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803379",
            "telephone_number": "574-269-8338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 DuBois Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465803210",
            "country_code": "US",
            "telephone_number": "574-267-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZECHIEL",
        "first_name": "MALLORI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-14",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71017866A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

Verify at the official NPI Registry.