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PARK CENTER INC
NPI 1306897004
Clinic/Center - Mental Health (Including Community Mental Health Center) in Fort Wayne, IN

Active since May 15, 2006CLIA 15D0960553 · Waiver
909 E STATE BLVD, FORT WAYNE, IN 46805(260) 481-2700(260) 481-2717 Get Directions Write a Review

NPPES record last updated: October 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 15, 2019, Aug 17, 2016 (2 updates tracked since 2016).

About Park Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARK CENTER INC (NPI 1306897004) is a healthcare organization registered as a mental health (including community mental health center) in Fort Wayne, Indiana and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2028, maintains 2 additional practice locations, and lists Kris Bigelow, Director Enterprise Credentialing &, as its authorized official.

NPPES Registry Identity

NPI1306897004
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NamePARK CENTER INC
Location Address909 E STATE BLVDFort Wayne, IN 46805-3404
Mailing Address11109 Parkview Plaza Drive, Mailbox 117Fort Wayne, IN 46845 · (260) 373-9700 · Fax (260) 373-9740
Phone(260) 481-2700
Fax(260) 481-2717
Organization SubpartNo
Authorized OfficialKris BigelowDirector Enterprise Credentialing & · (260) 266-1403
Enumeration DateMay 15, 2006
Last NPPES UpdateOctober 29, 20212 updates tracked since enumeration
NPPES CertifiedOctober 11, 2021
✔ NPI 1306897004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
License✔ Licensed in IN · 419-0-CMHC
Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
909 E STATE BLVD, Fort Wayne, IN 46805
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11610 Spy Run AveFort Wayne, IN 46805-4033 · Phone (260) 432-2502
Location 21909 Carew StFort Wayne, IN 46805-4707 · Phone (260) 481-2800

Other Identifiers 5

Medicaid100463190BIN
Medicaid100463190AIN
Other300024898IN · Addiction Services
Medicaid100463190 CIN
Other300015906IN · Addiction Services

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D0960553

Park Center Inc · Fort Wayne, IN
Active · expires Mar 26, 2028
CLIA Number15D0960553
Laboratory TypePhysician Office
Certificate Effective DateMarch 27, 2026
Certificate Expiration DateMarch 26, 2028
Laboratory DirectorDr. Ahsan Mahmood
Laboratory Phone(260) 481-2700
Laboratory LocationPark Center Inc909 E State Blvd, Fort Wayne, IN 46805
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COURTNEY LESLEY WASHINGTON
Counselor
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
JENNIFER PERRY MS
Counselor (Mental Health)
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
MICHELLE ELISE WIESE MD
Psychiatry & Neurology (Psychiatry)
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
SARAH MICHELLE MOORE APRN-CNM, PMHNP-BC
Nurse Practitioner
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
JULIE NAY WINN BS
Case Manager/Care Coordinator
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
TONYA J EIDEN LMHC, MS
Counselor (Mental Health)
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
ANGELA C DESPENZA LPN
Licensed Practical Nurse
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
MEGAN I FIGUEROA RN
Registered Nurse
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Park Center Inc's NPI number?

The NPI number for Park Center Inc is 1306897004. It was assigned to this organization in the NPPES registry on May 15, 2006.

Where is Park Center Inc located?

Park Center Inc is located at 909 E State Blvd, Fort Wayne, IN 46805. The listed phone number is (260) 481-2700.

What is Park Center Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Park Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D0960553) is associated with this NPI, valid through March 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Park Center Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Park Center Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Park Center Inc was last updated on October 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.