Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Julie Ann Funfrock, DO

Individual provider Family Medicine Physician · NPI 1144970575

Julie Ann Funfrock, DO is a Family Practice in Fort Wayne, Indiana. Qualified in 2022, 4 years ago. Practices with Credo Health Group LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Colorado and Indiana.

Years since qualifying
4
Licensed in
CO, IN
In the registry since
2022
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

10050 Auburn Park Dr
Fort Wayne, IN 46825-2389
Phone: (260) 432-6459
Fax: (260) 240-5284
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 02008137A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence TL.0009112 (CO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence TL.0009112 (CO)

Record details

NPI number1144970575
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 28, 2022
Last updated in NPPESJune 26, 2025
Certification dateJune 26, 2025
Mailing address10050 Auburn Park Dr, Fort Wayne, IN 46825-2389

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Credo Health Group Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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