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

Melodie A Gavin, RN

Individual provider Registered Nurse · NPI 1053725085

Melodie A Gavin, RN is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2018, 8 years ago. Practices with Park Center Inc, a 47-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
8
Licensed in
IN
In the registry since
2014
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

909 E State Blvd
Fort Wayne, IN 46805
Phone: (260) 481-2700
Fax: (260) 481-2709
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 71008261A (IN)
Registered Nurse Taxonomy 163W00000X · Licence 28184959A (IN)

Record details

NPI number1053725085
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorNo
NPI enumeratedJune 18, 2014
Last updated in NPPESOctober 11, 2022
Certification dateOctober 11, 2022
Mailing address909 E State Blvd, Fort Wayne, IN 46805-3404

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Park Center Inc — 47 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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