Active NPI
Candace Ntiamoah, FNP
- Family Nurse Practitioner
- Fort Wayne, IN
National Provider Identifier
1801629118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71016628A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28194594A | IN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Extended Care Specialists, Inc | Family | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.