LISA M. FEDDERKE (MIDWIFE) – Advanced Practice Midwife, NPI 1134530967
Advanced Practice Midwife
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
140 CERTIFIED NURSE MIDWIFE (CNM) in IN
Provider Addresses for LISA M. FEDDERKE (MIDWIFE)
11123 PARKVIEW PLAZA DR
FORT WAYNE, IN 468451707
Phone: (260) 425-6650
Fax: (260) 425-6649
Type: Location
3702 NEW VISION DR
BLDG B
FORT WAYNE, IN 468451703
Phone: (260) 266-8210
Fax: (260) 458-5636
Type: Mailing
442 W High St
Bryan, OH 435061681
Phone: (419) 636-4517
Fax: (419) 636-6438
Type: Location
8028 CARNEGIE BLVD STE 300
FORT WAYNE, IN 468045788
Phone: (260) 425-6650
Fax: (260) 755-6233
Type: Location
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 468451701
Phone: (260) 266-6013
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $232.
Total Amount is formed as General ($232) + Research ($0) + Ownership ($0) = $232.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: MAYNE PHARMA COMMERCIAL LLC ($63).
Total Amount
$232
General + Research + Ownership
Payments
12
Total payment records
General Amount
$232
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MAYNE PHARMA COMMERCIAL LLC | $63 |
| Astellas Pharma US Inc | $35 |
| Organon LLC | $31 |
| Sumitomo Pharma America, Inc. | $26 |
| CooperSurgical, Inc. | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-11-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171114000308 | I | Certified Nurse Midwife (Cnm) | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46845)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | NM | |
| - | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| - | IN | |
| - | IN | |
| Infectious Disease | IN | |
| Internal Medicine | IN | |
| - | IN |
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