Active NPI
Ali Cassandra Ross, NP-C
- Family Nurse Practitioner
- Fort Wayne, IN
National Provider Identifier
1922769744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71012038A
- Practice address
- 6326 Constitution Dr
Fort Wayne, IN 46804-1518 - Phone
- (650) 924-1174
- NPI assigned
- Jan 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71012038A | IN | Primary |
Addresses
Primary practice location
6326 Constitution Dr
Fort Wayne, IN 46804-1518
Mailing address
5850 Killdeer LN Apt 203
Fort Wayne, IN 46804-0041
Phone (574) 528-0547
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
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71012038A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RP Care LLC | Single Specialty | Current | Accepting new patients |
Locations
6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275
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": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1922769744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 KILLDEER LN APT 203",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468040041",
"telephone_number": "574-528-0547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6326 CONSTITUTION DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468041518",
"telephone_number": "650-924-1174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "ALI",
"middle_name": "CASSANDRA",
"credential": "NP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-04",
"last_updated": "2022-01-04",
"certification_date": "2022-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71012038A",
"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 Jan 4, 2022; 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.