Individual provider Active NPI

Mary Kathryn Thompson, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Wayne, IN
National Provider Identifier
1891582771
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28245296A Issued in IN
Practice address
6435 W Jefferson Blvd # 434
Fort Wayne, IN 46804-6203
Phone
(260) 436-7875
Fax
(260) 432-9812
NPI assigned
Apr 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28245296A IN Primary

Addresses

Primary practice location

6435 W Jefferson Blvd # 434
Fort Wayne, IN 46804-6203

Mailing address

PO Box 843603
Dallas, TX 75284-0001
Phone (972) 233-1999

Other names 1

  • Mary Foster Other name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28245296AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists of Fort Wayne PC Nurse Anesthetist, Certified Registered CurrentSince Apr 27, 2025 Accepting new patients

Locations

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

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

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

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

7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2999

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

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": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1891582771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840001",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6435 W JEFFERSON BLVD # 434",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046203",
            "telephone_number": "260-436-7875",
            "fax_number": "260-432-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28245296A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FOSTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.