Individual provider Active NPI

Mary Jacqueline Wharton, FNP-C

  • Hospitalist Physician
  • Marion, IN
National Provider Identifier
1992265904
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
28209999A Issued in IN
Practice address
441 N Wabash Ave
Marion, IN 46952-2612
Phone
(765) 660-6900
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28209999A IN
Hospitalist Physician 208M00000X 28209999A IN Primary

Addresses

Primary practice location

441 N Wabash Ave
Marion, IN 46952-2612

Mailing address

330 N Wabash
Ste G20
Marion, IN 46952
Phone (765) 660-7616

Other identifiers 2

IdentifierTypeStateIssuer
000001270272OtherINANTHEM
300025020MedicaidIN

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
I20190508002091 IN Practitioner - Nurse Practitioner 8224370465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adams County Memorial HospitalGroup PAC ID 0941198253, 85 clinicians
Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians

Practice addresses (Care Compare)

1100 Mercer Ave
Decatur, IN 46733-2303
Phone (260) 724-2145

900 Johnson St
Elkhart, IN 46514-3328
Phone (574) 747-8004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as group
Quality
76.47
Promoting interoperability
100
Improvement activities
40
Cost
68.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28209999AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adams County Memorial Hospital CurrentSince Nov 28, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 10, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 10, 2023 Accepting new patients
Adams County Memorial Hospital CurrentSince Nov 28, 2023 Accepting new patients

Locations

1100 Mercer Ave
Decatur, IN 46733

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

980 N Meridian St
Portland, IN 47371
Phone (260) 703-3312

1301 E National Hwy
Washington, IN 47501
Phone (812) 674-5372

Interoperability endpoints

  • Direct secure messaging: mary.wharton@4305.securemail.prognocis.com

Organizations & group practices 5

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1992265904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH",
            "address_2": "STE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "46952",
            "telephone_number": "765-660-7616",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 N WABASH AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522612",
            "telephone_number": "765-660-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHARTON",
        "first_name": "MARY",
        "middle_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28209999A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "28209999A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001270272",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300025020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.