KRISTA THORNBERRY PMHNP-BC
NPI 1710347059
Nurse Practitioner - Psychiatric/Mental Health in Fort Wayne, IN

Q: What is Krista Thornberry's NPI number?

The NPI number for Krista Thornberry is 1710347059. It was assigned to this individual provider in the NPPES registry on February 29, 2016.

Q: What is Krista Thornberry's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Krista Thornberry was last updated on August 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since February 29, 2016PECOS EnrolledAccepts Medicare Assignment

2200 RANDALLIA DR, FORT WAYNE, IN 46805(260) 344-4035(260) 969-9272 Get Directions Write a Review

NPPES record last updated: August 5, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 5, 2020, Oct 15, 2019, May 10, 2016 and 1 more (4 updates tracked since 2016).

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About Krista Thornberry Pmhnp-bc NPPES

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

KRISTA THORNBERRY PMHNP-BC (NPI 1710347059) is an individual psychiatric/mental health provider in Fort Wayne, Indiana, licensed in Indiana (71007032A) and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS and is a graduate of University Of South Alabama College Of Medicine (2015).

NPPES Registry Identity

NPI1710347059

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameKRISTA THORNBERRYCredential: PMHNP-BC

Location Address2200 RANDALLIA DRFort Wayne, IN 46805-4638

Mailing Address6435 W Jefferson Blvd Pmb 109Fort Wayne, IN 46804-6203 · (260) 344-4035 · Fax (260) 969-9272

Phone(260) 344-4035

Fax(260) 969-9272

Sole ProprietorNo

Medical School CMSUniversity Of South Alabama College Of MedicineGraduated 2015

Enumeration DateFebruary 29, 2016

Last NPPES UpdateAugust 5, 20204 updates tracked since enumeration

NPPES CertifiedAugust 5, 2020

✔ NPI 1710347059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in IN · 71007032A✔ Licensed in OH · RN.372896

2200 RANDALLIA DR, Fort Wayne, IN 46805

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, CareSource (Common Ground Healthcare), Group Health Cooperative-SCW and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Krista Thornberry Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052602158

PECOS Enrollment IDI20220506002201, I20220714003292, I20240130001692, I20240620001007, I20260501000935

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

27 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MALLIKA GYAWALI MD

Internal Medicine