Park Center Inc - Medicare Mental Health Clinic in Fort Wayne, IN

Park Center Inc is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Fort Wayne, Indiana. The current practice location for Park Center Inc is 909 E State Blvd, Fort Wayne, Indiana. For appointments, you can reach them via phone at (260) 481-2700. The mailing address for Park Center Inc is 11109 Parkview Plaza Drive, Mailbox 117, Fort Wayne, Indiana and phone number is (260) 373-9700.

Park Center Inc is licensed to practice in Indiana (license number 419-0-CMHC). The clinic also participates in the medicare program and its NPI number is 1306897004. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (260) 481-2700.

Contact Information

Park Center Inc
909 E State Blvd
Fort Wayne
IN 46805-3404
(260) 481-2700
(260) 481-2717

Map and Direction


Mental Health Clinic Profile

Full NamePark Center Inc
SpecialityClinic/Center
Location909 E State Blvd, Fort Wayne, Indiana
Authorized Official Name and PositionKris Bigelow (DIRECTOR ENTERPRISE CREDENTIALING &)
Authorized Official Contact2602661403
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Park Center Inc
11109 Parkview Plaza Drive
Mailbox 117
Fort Wayne
IN 46845

Ph: (260) 373-9700
Park Center Inc
909 E State Blvd
Fort Wayne
IN 46805-3404

Ph: (260) 481-2700

NPI Details:

NPI Number1306897004
Provider Enumeration Date05/15/2006
Last Update Date10/29/2021
Certification Date10/11/2021

Medicare PECOS Information:

Medicare PECOS PAC ID5991794794
Medicare Enrollment IDO20041213000226

Medical Identifiers

Medical identifiers for Park Center Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1306897004NPI-NPPES
100463190 CMedicaidIN
100463190BMedicaidIN
300015906OtherINADDICTION SERVICES
100463190AMedicaidIN
300024898OtherINADDICTION SERVICES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TA0400XPsychologist - Addiction (substance Use Disorder) (* (Not Available))Secondary
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) 419-0-CMHC (Indiana)Primary
261QP2300XClinic/center - Primary Care (Indiana)Secondary
261QR0405XClinic/center - Rehabilitation, Substance Use Disorder (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Park Center Inc acts as a billing entity for following providers:
Provider NameIrene Theresa Hoover
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639103153
PECOS PAC ID: 2860475514
Enrollment ID: I20040611001290
Provider NameSamir Gamal Ishak
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1548257488
PECOS PAC ID: 4880655331
Enrollment ID: I20041019001023
Provider NameEdith L Kenna
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1154358406
PECOS PAC ID: 0446212625
Enrollment ID: I20041029000919
Provider NameJames H Cheviron
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1588806103
PECOS PAC ID: 9830156579
Enrollment ID: I20041215000070
Provider NameJason T Cook
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1043283641
PECOS PAC ID: 7618928821
Enrollment ID: I20050204000566
Provider NameRichard L Hite
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1124087036
PECOS PAC ID: 1052354461
Enrollment ID: I20050607000522
Provider NameJody D Dietsch
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1629324850
PECOS PAC ID: 8224069489
Enrollment ID: I20050826000732
Provider NameAmanda L Mayle
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1003865395
PECOS PAC ID: 6406878628
Enrollment ID: I20051230000380
Provider NameAnthony D Jeffers
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1467423863
PECOS PAC ID: 9032125976
Enrollment ID: I20060301000431
Provider NameJinny R Broderick
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1558441717
PECOS PAC ID: 8820191158
Enrollment ID: I20070307000226
Provider NameKaren S Lothamer
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1699823492
PECOS PAC ID: 9830294545
Enrollment ID: I20070424000668
Provider NameAjaz Iqbal
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1477616753
PECOS PAC ID: 1254438112
Enrollment ID: I20070530000076
Provider NameSyed Hasan
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1619909991
PECOS PAC ID: 6800782137
Enrollment ID: I20070619000008
Provider NameGladys A Beale
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1164401063
PECOS PAC ID: 2466535224
Enrollment ID: I20080218000008
Provider NameFrank Shao
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1982683736
PECOS PAC ID: 1052494853
Enrollment ID: I20080218000368
Provider NameAlan Breier
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1598924334
PECOS PAC ID: 6507938263
Enrollment ID: I20080712000103
Provider NameCatherine A Duchovic
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1558444984
PECOS PAC ID: 8224104427
Enrollment ID: I20080912000321
Provider NameJanet B Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134379688
PECOS PAC ID: 7214097054
Enrollment ID: I20081124000305
Provider NameSandra J Klinker
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1710926225
PECOS PAC ID: 7012074651
Enrollment ID: I20090325000652
Provider NameSarah Byerley Harber
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1992938393
PECOS PAC ID: 4688710486
Enrollment ID: I20091008000305
Provider NameAhsan Mahmood
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1760458921
PECOS PAC ID: 8921047473
Enrollment ID: I20100519000617
Provider NameViann Grace Ellsworth
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1952378895
PECOS PAC ID: 8527198597
Enrollment ID: I20100617000839
Provider NameMarjorie L Burns
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1053328260
PECOS PAC ID: 8123211406
Enrollment ID: I20101019000884
Provider NameJames Keifer
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1336329333
PECOS PAC ID: 1759576606
Enrollment ID: I20101117000660
Provider NameIna S Carlson
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1265490650
PECOS PAC ID: 0244425122
Enrollment ID: I20101117001044
Provider NameDeborah S Baker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467630061
PECOS PAC ID: 6406044734
Enrollment ID: I20101230000369
Provider NameRonald J Pancner
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1316980576
PECOS PAC ID: 0547291031
Enrollment ID: I20110520000119
Provider NameAlicia A Elliott
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1699071100
PECOS PAC ID: 1759553225
Enrollment ID: I20111005000071
Provider NameLaura M Folds
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306129283
PECOS PAC ID: 5496920936
Enrollment ID: I20111212000133
Provider NameRichard Lamar Cain
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336410703
PECOS PAC ID: 7618102310
Enrollment ID: I20131106000267
Provider NameCyrus D Solhkhah
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1174710347
PECOS PAC ID: 0547249088
Enrollment ID: I20140114000743
Provider NameDoris M Williams
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1891966792
PECOS PAC ID: 3870776354
Enrollment ID: I20140707001744
Provider NameNicole A Deller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114157641
PECOS PAC ID: 5193947141
Enrollment ID: I20141107000541
Provider NameBrian Flesch
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1821043555
PECOS PAC ID: 3971815259
Enrollment ID: I20150629001835
Provider NameElizabeth A Pfeiffer
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1124252879
PECOS PAC ID: 6305065756
Enrollment ID: I20150827000975
Provider NameJenifer L Vohs
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1376823641
PECOS PAC ID: 6709183288
Enrollment ID: I20160329000210
Provider NameMelinda Davis
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1093168718
PECOS PAC ID: 9638464019
Enrollment ID: I20160824001453
Provider NameRebecca Haynes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326577354
PECOS PAC ID: 5597035758
Enrollment ID: I20170720000752
Provider NameAmanda Lowe
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1780093625
PECOS PAC ID: 8628336146
Enrollment ID: I20171211000902
Provider NameCynthia M Shepherd
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912435058
PECOS PAC ID: 4880952852
Enrollment ID: I20171220002120
Provider NameTimothy Kowaleski
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083093272
PECOS PAC ID: 2062724685
Enrollment ID: I20180523001656
Provider NameNicholas J Todoran
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1003369273
PECOS PAC ID: 8628325933
Enrollment ID: I20180718000987
Provider NamePamela Sue Thornton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609361062
PECOS PAC ID: 2567710619
Enrollment ID: I20180806001757
Provider NameAndrea H Naaum
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1487071809
PECOS PAC ID: 0143510248
Enrollment ID: I20180810000287
Provider NameJessica Tullis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568951887
PECOS PAC ID: 5395095145
Enrollment ID: I20180829001579
Provider NameValerie J Rumple
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174706691
PECOS PAC ID: 7012260185
Enrollment ID: I20181019002049
Provider NameCourtney L Washington
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1003121104
PECOS PAC ID: 4284987355
Enrollment ID: I20181019002104
Provider NameAndrew Smith
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1295171734
PECOS PAC ID: 9537420245
Enrollment ID: I20181107002889
Provider NameAmanda M Wyatt
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1811349335
PECOS PAC ID: 4082968128
Enrollment ID: I20181108001814
Provider NameEvan Goodman
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1588107569
PECOS PAC ID: 9739423583
Enrollment ID: I20181205000199
Provider NameMelodie A Gavin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053725085
PECOS PAC ID: 3274877030
Enrollment ID: I20181205000290
Provider NameChelsea Crago
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1730557638
PECOS PAC ID: 0648514257
Enrollment ID: I20181210001364
Provider NameTeresa L Roberts
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184911158
PECOS PAC ID: 0547504094
Enrollment ID: I20181210003201
Provider NameLaura Michelle Oyer
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1356776025
PECOS PAC ID: 4587907506
Enrollment ID: I20190515000384
Provider NameCaroline R Braun
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1497221691
PECOS PAC ID: 8729311469
Enrollment ID: I20190611002819
Provider NameSherri Sue Albertson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609437425
PECOS PAC ID: 9234464892
Enrollment ID: I20190718002060
Provider NameJasmine J Kaur
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1992113492
PECOS PAC ID: 4688891476
Enrollment ID: I20190822000781
Provider NameDaniel Clayton Brewer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205497401
PECOS PAC ID: 2860720745
Enrollment ID: I20190830000869
Provider NameMahrokh Shayanpour
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1992120935
PECOS PAC ID: 7517239197
Enrollment ID: I20191004000896
Provider NameAmbreen Ghori
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1326458514
PECOS PAC ID: 5496046732
Enrollment ID: I20200116002797
Provider NameDanielle R Allen
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1821528878
PECOS PAC ID: 6608204086
Enrollment ID: I20200318000903
Provider NameMiranda Ellen Renee Kolde
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1477066538
PECOS PAC ID: 6901235837
Enrollment ID: I20200328000078
Provider NameMegan Elizabeth Waters
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1568983443
PECOS PAC ID: 9739595992
Enrollment ID: I20210312001040
Provider NameKaitlyn J Chittick-myers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790301257
PECOS PAC ID: 8527475383
Enrollment ID: I20210324000767
Provider NameManpreet Khemka
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1457509903
PECOS PAC ID: 6709017072
Enrollment ID: I20210401000981
Provider NameDeepak Khemka
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1396922977
PECOS PAC ID: 0345499927
Enrollment ID: I20210401001832
Provider NameNathan Reig Miner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932793478
PECOS PAC ID: 9739597154
Enrollment ID: I20210422002471
Provider NameRachel G Lilly
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1891223020
PECOS PAC ID: 5294085239
Enrollment ID: I20210629000163
Provider NameCarmen Mae Stoller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215609821
PECOS PAC ID: 0941690168
Enrollment ID: I20211202001173
Provider NameCassandra G Winters
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1790326312
PECOS PAC ID: 4183005812
Enrollment ID: I20220713000519
Provider NameChristianah Agunanne
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477212140
PECOS PAC ID: 8022493014
Enrollment ID: I20220912001491
Provider NameSheila Wolfrum
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194355982
PECOS PAC ID: 0345618955
Enrollment ID: I20221201000754
Provider NameSara Coburn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861115750
PECOS PAC ID: 5395113989
Enrollment ID: I20221202000620
Provider NameCorry Hawkins
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1841886884
PECOS PAC ID: 9133533995
Enrollment ID: I20221227000325
Provider NameKristen Alison Varian
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1639621766
PECOS PAC ID: 4385016088
Enrollment ID: I20230206002359
Provider NameGanit Anna Gray
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1215645551
PECOS PAC ID: 8820456163
Enrollment ID: I20230620001191
Provider NameChad R Percifield
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1629569140
PECOS PAC ID: 4880941178
Enrollment ID: I20230628000288
Provider NameSarah Michelle Moore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003459561
PECOS PAC ID: 3072977230
Enrollment ID: I20230907000795
Provider NameAkira Tsunawaki
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780395814
PECOS PAC ID: 0749635621
Enrollment ID: I20231012001677
Provider NameStacia Elizabeth Springer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306322177
PECOS PAC ID: 3476802760
Enrollment ID: I20231030002002
Provider NameSean P Andes
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1295096865
PECOS PAC ID: 5597113951
Enrollment ID: I20231122002459
Provider NameJacqueline Bondowski
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1679250252
PECOS PAC ID: 1850749219
Enrollment ID: I20231122002483
Provider NameLydia Elaine Hentz
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1952941908
PECOS PAC ID: 9234587601
Enrollment ID: I20231122002820
Provider NameJonathan Mayes
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1356733943
PECOS PAC ID: 9436507860
Enrollment ID: I20231127000800
Provider NameVanessa Michelle Hogan
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1508087842
PECOS PAC ID: 7517315948
Enrollment ID: I20231127000828
Provider NameLaura R Murphy
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1861682114
PECOS PAC ID: 4587012927
Enrollment ID: I20231127001025
Provider NameWenyao Yu
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1720772023
PECOS PAC ID: 9537517982
Enrollment ID: I20231127001606
Provider NameKimberly K Smith
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1972789600
PECOS PAC ID: 5597113829
Enrollment ID: I20231128001398
Provider NameTaylor Dawn Saunders
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1043869829
PECOS PAC ID: 8729436068
Enrollment ID: I20231128001925
Provider NameTabitha Frentz
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1700642659
PECOS PAC ID: 8325484405
Enrollment ID: I20240312000631

Reviews and Comments

Clinic/Center in Fort Wayne, IN

Prometheus Psychological Services
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Phone: 260-409-8188    
Christina Stapleton, L.l.c
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Oaktree Guidance & Wellness Center
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Practice Location: 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825
Phone: 260-570-4515    Fax: 260-209-0762
Courageous Healing Inc
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Medicare: Not Enrolled in Medicare
Practice Location: 2013 S Anthony Blvd, Fort Wayne, IN 46803
Phone: 260-417-4801    
Raj Clinics Professional Services Corporation
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 315 Airport North Office Park, Fort Wayne, IN 46825
Phone: 574-732-1166    Fax: 574-753-4117
Sharon Mowrer Counseling And Consulting Pc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1415 Magnavox Way, Suite 120, Fort Wayne, IN 46804
Phone: 260-760-8645    
A.w. Holdings, Llc
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Medicare: Not Enrolled in Medicare
Practice Location: 3900 Hursh Rd, Fort Wayne, IN 46845
Phone: 260-637-3608    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.