Individual provider Active NPI

Rebecca Chantelois, NP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1992362131
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71009085A Issued in IN
Practice address
8233 Glencarin Blvd
Fort Wayne, IN 46804-5784
Phone
(260) 425-5470
Fax
(260) 425-5475
NPI assigned
May 23, 2019
Last updated
Oct 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71009085A IN Primary

Addresses

Primary practice location

8233 Glencarin Blvd
Fort Wayne, IN 46804-5784

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rchantelois196941@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190827003313 IN Practitioner - Nurse Practitioner 1557699618 Reassigns benefits to 4 organizations
I20250417001136 MI Practitioner - Nurse Practitioner 1557699618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

1010 N Main St
Bluffton, IN 46714-1321
Phone (260) 261-1385

1732 W N St
Kendallville, IN 46755-2850
Phone (931) 253-1110

4152 W State Rd
Suite 56
Hanover, IN 47243-9070
Phone (901) 351-1791

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71009085AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FC Indiana, LLC Nurse Practitioner CurrentSince Apr 19, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Mar 11, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Mar 11, 2024 Accepting new patients
FC Indiana, LLC CurrentSince Apr 19, 2024 Accepting new patients
Parkview Health System Inc Nurse Practitioner Current Accepting new patients
Parkview Health System, Inc. Nurse Practitioner CurrentSince Sep 18, 2019 Accepting new patients
Transitions Health Network LLC Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

2418 16th St
Bedford, IN 47421
Phone (812) 278-3154

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

3909 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-8000

1159 W Jefferson St
Ste 204
Franklin, IN 46131

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

1732 W North St
Kendallville, IN 46755
Phone (260) 544-8054

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: rchantelois196941@direct.parkviewexchange.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1992362131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8233 GLENCARIN BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045784",
            "telephone_number": "260-425-5470",
            "fax_number": "260-425-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANTELOIS",
        "first_name": "REBECCA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009085A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rchantelois196941@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "2280 Provident Ct",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2280 Provident Ct",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2280 Provident Ct",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.