Look up the most recent NPI and PECOS records

Melissa K. Gephart

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

7900 W Jefferson Blvd Ste 304, Fort Wayne, IN 46804-4128

PECOS Enrollment

This provider is enrolled in PECOS as MELISSA GEPHART.

Based on the most recent information from CMS, provider Melissa K. Gephart is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1174893531
Provider Type
Individual
Full Name
Gephart, Melissa K.
Credential
NP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
1/3/2012
Last Updated
9/23/2020

Contact Information

Practice Location

7900 W Jefferson Blvd Ste 304, Fort Wayne, IN 46804-4128

(260) 458-3600

(260) 458-3601

Mailing Location

6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934

(260) 479-3514

(260) 479-3520

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 71003834A Indiana

Provider Identifiers

ID	Description	Issuer
ID 000000744783	Description Other	Issuer ANTHEM BCBS Indiana
ID 71003834A	Description Other	Issuer INDIANA PROFESSIONAL NURSING BOARD LICENSE Indiana
ID 201044550	Description Medicaid	Issuer Unlisted Indiana

Melissa K. Gephart

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Hernandez, Jacqueline J.

Gorrell, Cynthia K

Schlatter, Andrew J.

Richardson, Kristy J

Rodriguez, Laura L

Ritchie, Jennifer Lynn

Krill, Lisa Kay

Hillen, Jenna

Rounding Providers

Grimshaw, John