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

Kerrick Marie Mathis

Individual provider Nurse Practitioner · NPI 1053084319

Kerrick Marie Mathis is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2021, 5 years ago. Practices with Parkview Health System Inc, a 1,336-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
5
Licensed in
IN
In the registry since
2021
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Practice location Address checks out

11055 Twin Creeks Cv
Fort Wayne, IN 46845-2204
Phone: (260) 425-6120
Fax: (260) 425-6115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71011565A (IN)

Record details

NPI number1053084319
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 31, 2021
Last updated in NPPESDecember 2, 2024
Certification dateDecember 2, 2024
Mailing address11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Parkview Health System Inc — 1336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fort Wayne