Individual provider Active NPI

Vivian Pashova, FNP-C

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1821854563
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014942A Issued in IN
Practice address
7222 Engle Rd.
Fort Wayne, IN 46804
Phone
(260) 432-5005
NPI assigned
Feb 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71014942A IN Primary

Addresses

Primary practice location

7222 Engle Rd.
Fort Wayne, IN 46804

Mailing address

7222 Engle Rd.
Fort Wayne, IN 46804

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
I20240419001546 IN Practitioner - Nurse Practitioner 7810336138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy and Asthma Center, PCGroup PAC ID 4587567391, 6 clinicians

Practice addresses (Care Compare)

7222 Eagle Rd
Fort Wayne, IN 46804-2222
Phone (260) 432-5005

Hospital & facility affiliations

  • Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy & Asthma Center, PC CurrentSince Apr 1, 2024 Accepting new patients
Patel Familymedicine Past Accepting new patients

Locations

10415 Leo Rd
Fort Wayne, IN 46825
Phone (260) 432-5005

7222 Engle Rd
Fort Wayne, IN 46804
Phone (260) 432-5005

2280 Provident Ct
Ste A
Warsaw, IN 46580
Phone (260) 432-5005

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1821854563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7222 ENGLE RD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7222 ENGLE RD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "260-432-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASHOVA",
        "first_name": "VIVIAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014942A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.