Individual provider Active NPI

Candace Ntiamoah, FNP

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1801629118
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71016628A Issued in IN
Practice address
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone
(877) 504-2049
Fax
(260) 483-9196
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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 28194594A IN
Family Nurse Practitioner 363LF0000X 71016628A IN Primary

Addresses

Primary practice location

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Mailing address

PO Box 1431
Dept 400
Charlotte, NC 28201-1431
Phone (877) 504-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Little Brook Rd
West Wareham, MA 02576-1222

134 Cherokee Dr
Mooresville, NC 28117-9031

3800 W 80TH LN
Merrillville, IN 46410-5052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28194594AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Extended Care Specialists, Inc Family CurrentSince Jul 1, 2026 Accepting new patients

Locations

3512 Stellhorn Rd
Fort Wayne, IN 46815

8398 Mississippi St
Fl 2
Merrillville, IN 46410

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.

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1801629118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1431",
            "address_2": "DEPT 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282011431",
            "telephone_number": "877-504-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154631",
            "telephone_number": "877-504-2049",
            "fax_number": "260-483-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTIAMOAH",
        "first_name": "CANDACE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28194594A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016628A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.