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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: October 18, 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 ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Park Center Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

101

Medicare enrollment records show 101 clinicians reassign Medicare billing to Park Center Inc, which bills Medicare for the services they deliver. Of these, 44 practice at this address and 86 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Clinical Social Worker25
Nurse Practitioner22
Mental Health Counselor21
Psychiatry16
Clinical Psychologist9
Marriage and Family Therapist5
Certified Clinical Nurse Specialist (CNS)2
Family Practice1

Nearest to this location (20)

See all 101
Janet Anderson, RN FNP
Nurse Practitioner
NPI 1134379688
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Sean Andes, MS
Mental Health Counselor
NPI 1295096865
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Caroline Braun
Clinical Social Worker
NPI 1497221691
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Daniel Brewer
Nurse Practitioner
NPI 1205497401
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Sara Coburn
Nurse Practitioner
NPI 1861115750
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Jessica Crozier
Clinical Social Worker
NPI 1588541866
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Melissa Finefrock, LMFT
Marriage and Family Therapist
NPI 1043767080
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Brian Flesch, MSW, LCSW
Clinical Social Worker
NPI 1821043555
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Jessica Gabbard, LMHCA (TEMP)
Mental Health Counselor
NPI 1861146433
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Melodie Gavin, RN
Nurse Practitioner
NPI 1053725085
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Evan Goodman
Clinical Psychologist
NPI 1588107569
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 482-9125
✔ PECOS✔ Accepts MedicareSame address
Sean Hall, LMHC
Mental Health Counselor
NPI 1851109771
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Richard Hite, PH.D., HSPP
Clinical Psychologist
NPI 1124087036
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOSSame address
Jill Lane, MS, MHC
Mental Health Counselor
NPI 1467693242
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Carmella Oneal, LMFT
Marriage and Family Therapist
NPI 1548506728
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Chad Percifield, DO
Psychiatry
NPI 1629569140
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Rashad Slate, MS ED
Marriage and Family Therapist
NPI 1326302498
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Courtney Washington
Clinical Psychologist
NPI 1003121104
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Michelle Wiese, MD
Psychiatry
NPI 1003348343
909 E STATE BLVD
Fort Wayne, IN 46805
(260) 481-2700
✔ PECOS✔ Accepts MedicareSame address
Ajaz Iqbal, MD
Psychiatry
NPI 1477616753
909 E STATE BLVD
Fort Wayne, IN 46805
(206) 481-2700
✔ PECOSSame address
See all 101 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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.

Is Park Center Inc enrolled in Medicare?

Yes. Park Center Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Park Center Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 101 clinicians in 8 Medicare specialties reassign their Medicare billing to Park Center Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (25), Nurse Practitioner (22) and Mental Health Counselor (21). Of these, 44 practice at this address and 86 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 and 1 other insurer 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.