Active NPI
Alexis Irene McClure, PA
- Physician Assistant
- Peru, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10005026A
- Practice address
- 750 N Broadway
Peru, IN 46970-1027 - Phone
- (260) 569-2120
- NPI assigned
- Dec 9, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 99999999999 | IN | |
| Physician Assistant | 363A00000X | 10005026A | IN | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
750 N Broadway
Peru, IN 46970-1027
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other practice location 1
1050 Wishard Blvd
Indianapolis, IN 46202-2872
Phone (317) 410-3911
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11109 Parkview Plaza Dr
Suite 117
Fort Wayne, IN 46845-1701
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99999999999 | IN | MD | Pediatrics Physician |
| 10005026A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Wabash Hospital, Inc. | Pediatrics | Current | Accepting new patients |
| Parkview Health System Inc | Pediatrics | Current | Accepting new patients |
| Parkview Wabash Hospital, Inc. | Current | Accepting new patients | |
| Parkview Wabash Hospital, Inc. | Past | 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
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
1104 N Wayne St
North Manchester, IN 46962
Phone (260) 982-2102
750 N Broadway
Peru, IN 46970
Phone (260) 569-2120
8 John Kissinger Dr
Wabash, IN 46992
Phone (260) 563-7421
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.
-
- Rural Health Clinic/Center
- Wabash, IN
- NPI 1982103511
-
- Critical Access Hospital
- Wabash, IN
- NPI 1245259878
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761782400000",
"number": "1780490235",
"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": "750 N BROADWAY",
"city": "PERU",
"state": "IN",
"postal_code": "469701027",
"telephone_number": "260-569-2120"
}
],
"practiceLocations": [
{
"address_1": "1050 Wishard Blvd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462022872",
"country_code": "US",
"telephone_number": "317-410-3911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLURE",
"first_name": "ALEXIS",
"middle_name": "IRENE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-09",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "99999999999",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10005026A",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peru, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.