Individual provider Active NPI

Sonja Lynne Norman, AGAC-NP

  • Acute Care Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1780304162
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71013287A Issued in IN
Practice address
702 Van Buren St
Fort Wayne, IN 46802-3697
Phone
(260) 425-3000
NPI assigned
Aug 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 28162270A IN
Acute Care Nurse Practitioner 363LA2100X 71013287A IN Primary

Addresses

Primary practice location

702 Van Buren St
Fort Wayne, IN 46802-3697

Mailing address

16209 Havenwood Dr
Woodburn, IN 46797-9585
Phone (260) 437-7560

Other names 1

  • Sonja Lynne Notestine 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
I20221207002755 IN Practitioner - Nurse Practitioner 1355710716 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28162270AINMDCritical Care Medicine Registered Nurse
71013287AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RP Care LLC CurrentSince Jul 1, 2023 Accepting new patients
Hospitalist Physicians of Indiana, PC CurrentSince Aug 1, 2023 Accepting new patients
Hospital Care Group, P.C. CurrentSince Dec 1, 2022 Accepting new patients

Locations

303 S Main St
Bluffton, IN 46714
Phone (260) 824-0800

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

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.

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1780304162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16209 HAVENWOOD DR",
            "city": "WOODBURN",
            "state": "IN",
            "postal_code": "467979585",
            "telephone_number": "260-437-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 VAN BUREN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023697",
            "telephone_number": "260-425-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "SONJA",
        "middle_name": "LYNNE",
        "credential": "AGAC-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IN",
            "license": "28162270A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71013287A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONJA",
            "last_name": "NOTESTINE",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.