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JENNIFER DIANE MATA
NPI 1922747294
Nurse Practitioner in Fort Wayne, IN

Active since June 03, 2022
2121 LAKE AVE, FORT WAYNE, IN 46805(260) 426-5431 Get Directions Write a Review

NPPES record last updated: May 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jennifer Diane Mata NPPES

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

JENNIFER DIANE MATA (NPI 1922747294) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (71014672A) and active in the NPI registry since June 2022.

NPPES Registry Identity

NPI1922747294
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJENNIFER DIANE MATA
Location Address2121 LAKE AVEFort Wayne, IN 46805-5100
Mailing Address2121 Lake AveFort Wayne, IN 46805-5100
Phone(260) 426-5431
Sole ProprietorYes
Enumeration DateJune 3, 2022
Last NPPES UpdateMay 17, 2024
NPPES CertifiedMay 17, 2024
✔ NPI 1922747294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IN · 71014672A
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 71014672A (IN)
2121 LAKE AVE, Fort Wayne, IN 46805
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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.

TAMMY MOEHLE
Registered Nurse (Oncology)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. CALEB ANDREW MOSSBURG PHARMD
Pharmacist
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. ASHLEY M FULTON PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
HANNAH DULINSKY RN
Registered Nurse (Home Health)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 460-1445
DANIELLE SCHULTZ
Registered Nurse
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. IAN H. COOK M.D.
Surgery
2121 LAKE AVE, VETERANS AFFAIRS MEDICAL CENTER
FORT WAYNE, IN 46805
Allen County (260) 426-5431
SCOTT KRUSE
Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
MONICA JANE HALL
Registered Nurse (General Practice)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 456-0543

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 Jennifer Mata's NPI number?

The NPI number for Jennifer Mata is 1922747294. It was assigned to this individual provider in the NPPES registry on June 3, 2022.

Where is Jennifer Mata located?

Jennifer Mata practices at 2121 Lake Ave, Fort Wayne, IN 46805. The listed phone number is (260) 426-5431.

What is Jennifer Mata's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Jennifer Mata was last updated on May 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.