Extended Care Specialists, Inc | |
3512 Stellhorn Rd Fort Wayne IN 46815 | |
(260) 483-9081 | |
(260) 483-9196 |
Full Name | Extended Care Specialists, Inc |
---|---|
Speciality | Family Medicine |
Location | 3512 Stellhorn Rd, Fort Wayne, Indiana |
Authorized Official Name and Position | Jennifer Rucci (OWNER) |
Authorized Official Contact | 2604839081 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Extended Care Specialists, Inc Po Box 392552 Pittsburgh PA 15251-9552 Ph: (260) 483-9081 | Extended Care Specialists, Inc 3512 Stellhorn Rd Fort Wayne IN 46815 Ph: (260) 483-9081 |
NPI Number | 1134146079 |
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Provider Enumeration Date | 07/16/2006 |
Last Update Date | 07/31/2024 |
Certification Date | 07/31/2024 |
Medicare PECOS PAC ID | 2466407713 |
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Medicare Enrollment ID | O20050318000726 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134146079 | NPI | - | NPPES |
H714830 | Other | OH | GROUP NUMBER |
224350 | Other | IN | GROUP NUMBER |
K304000 | Other | KY | GROUP NUMBER |
Provider Name | Susan K Halley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891716312 PECOS PAC ID: 0941271241 Enrollment ID: I20040802000840 |
Provider Name | Mary H Rose |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1891856399 PECOS PAC ID: 2961473863 Enrollment ID: I20040804000593 |
Provider Name | Kelly Jo Trieglaff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508991902 PECOS PAC ID: 2668449539 Enrollment ID: I20040911000186 |
Provider Name | Joyce Mcmahon Palmateer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700867058 PECOS PAC ID: 9739148891 Enrollment ID: I20041005001207 |
Provider Name | Vahid-david Sedaghat |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972584043 PECOS PAC ID: 5496714941 Enrollment ID: I20041008000991 |
Provider Name | Mary Catherine Parker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386661064 PECOS PAC ID: 3971558222 Enrollment ID: I20050322000064 |
Provider Name | Steven Delee |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407845001 PECOS PAC ID: 1658329461 Enrollment ID: I20050621001018 |
Provider Name | Thomas P Van Den Driessche |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1073507745 PECOS PAC ID: 3678592292 Enrollment ID: I20051114000365 |
Provider Name | Amy E Nugent |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245299288 PECOS PAC ID: 1456352780 Enrollment ID: I20070129000548 |
Provider Name | Donald Wolfram |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669499257 PECOS PAC ID: 7113020009 Enrollment ID: I20070314000177 |
Provider Name | Ruth Marie Poppele |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851375364 PECOS PAC ID: 0345340477 Enrollment ID: I20070703000073 |
Provider Name | Kevin D Neese |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1699710319 PECOS PAC ID: 6800867383 Enrollment ID: I20071016000210 |
Provider Name | Paul T Kaplanis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497860167 PECOS PAC ID: 4981767696 Enrollment ID: I20090107000089 |
Provider Name | Kristi S Buis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205088283 PECOS PAC ID: 2163571092 Enrollment ID: I20090522000220 |
Provider Name | Cheryl Davis-land |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740335702 PECOS PAC ID: 8921147596 Enrollment ID: I20091120000563 |
Provider Name | Nina Scott |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497730535 PECOS PAC ID: 0042353229 Enrollment ID: I20100210000516 |
Provider Name | Kevin M Conlee |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1548331747 PECOS PAC ID: 1951446921 Enrollment ID: I20100303000144 |
Provider Name | Ashley M Marshall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386875094 PECOS PAC ID: 8426180258 Enrollment ID: I20100714000830 |
Provider Name | Kelly J Butler |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1518960681 PECOS PAC ID: 6608062443 Enrollment ID: I20101119000196 |
Provider Name | Lisa J Omo Griffith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629399696 PECOS PAC ID: 6709072853 Enrollment ID: I20101201000449 |
Provider Name | Rachel Renee Holcomb |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356675409 PECOS PAC ID: 9436291655 Enrollment ID: I20101206000547 |
Provider Name | Pragneshkumar N Radadiya |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1548421985 PECOS PAC ID: 4880886621 Enrollment ID: I20110620000655 |
Provider Name | Amy M Howard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760764351 PECOS PAC ID: 7315118353 Enrollment ID: I20110922000375 |
Provider Name | Steven Shelton |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1215934310 PECOS PAC ID: 6406754910 Enrollment ID: I20110930000216 |
Provider Name | Tina L Geary |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083632616 PECOS PAC ID: 4587640909 Enrollment ID: I20111104000575 |
Provider Name | Johnell J Treesh Valentine |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417256702 PECOS PAC ID: 6305004417 Enrollment ID: I20120221000583 |
Provider Name | Julienne E Leyva |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972762516 PECOS PAC ID: 8224298641 Enrollment ID: I20120322000204 |
Provider Name | Kimberly A Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225387400 PECOS PAC ID: 3274782156 Enrollment ID: I20121009000813 |
Provider Name | Natalie S Macdonald |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730429994 PECOS PAC ID: 4082851464 Enrollment ID: I20130501000467 |
Provider Name | Michelle M Diss |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497198568 PECOS PAC ID: 9537307400 Enrollment ID: I20130605000052 |
Provider Name | Kimberly Schoengart |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427300060 PECOS PAC ID: 7719128750 Enrollment ID: I20130802000295 |
Provider Name | Richard Lamar Cain |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336410703 PECOS PAC ID: 7618102310 Enrollment ID: I20131106000267 |
Provider Name | Stacey J Brames |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932533742 PECOS PAC ID: 4183850654 Enrollment ID: I20131112001376 |
Provider Name | Susan Soares |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1447550272 PECOS PAC ID: 5092948356 Enrollment ID: I20140513000118 |
Provider Name | Jennifer L Miskov |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114263233 PECOS PAC ID: 1153566864 Enrollment ID: I20140814002079 |
Provider Name | Susan M Maloney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811276751 PECOS PAC ID: 9335461938 Enrollment ID: I20141210001633 |
Provider Name | Jennifer J Krohn |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780083873 PECOS PAC ID: 9032439179 Enrollment ID: I20150513001586 |
Provider Name | Jennifer Nicole Kramer |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1679958490 PECOS PAC ID: 2769796341 Enrollment ID: I20150728004050 |
Provider Name | Bridgit Lee Malone |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629456454 PECOS PAC ID: 5294040283 Enrollment ID: I20150820009949 |
Provider Name | Kourtney Ellen Green |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972910602 PECOS PAC ID: 6406163070 Enrollment ID: I20150915000105 |
Provider Name | Geraldine Elizabeth Darkwood |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730556267 PECOS PAC ID: 0648587709 Enrollment ID: I20150922002021 |
Provider Name | Allison Snyder |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982027785 PECOS PAC ID: 0941518187 Enrollment ID: I20151007002593 |
Provider Name | Sheila M Hoch |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639557556 PECOS PAC ID: 1850600024 Enrollment ID: I20151029001036 |
Provider Name | Jessica Arce |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972964484 PECOS PAC ID: 3577857655 Enrollment ID: I20160812000112 |
Provider Name | Sara A Golden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114378635 PECOS PAC ID: 9638466196 Enrollment ID: I20160927001252 |
Provider Name | Amanda Jo Velez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952757528 PECOS PAC ID: 8527355031 Enrollment ID: I20160928000112 |
Provider Name | Carrie Lee Dobbins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295282267 PECOS PAC ID: 1557640422 Enrollment ID: I20161116002207 |
Provider Name | Elisha Clouse |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407122351 PECOS PAC ID: 5193989085 Enrollment ID: I20161205000180 |
Provider Name | Cathryn Lynn Jenkins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831231372 PECOS PAC ID: 5890868822 Enrollment ID: I20161213001463 |
Provider Name | Amber N Handshoe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073034500 PECOS PAC ID: 5496025611 Enrollment ID: I20170720003060 |
Provider Name | Melissa L Parker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649797655 PECOS PAC ID: 3577836626 Enrollment ID: I20170912000856 |
Provider Name | Kimberly A Hadler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770697062 PECOS PAC ID: 0648248252 Enrollment ID: I20180718000268 |
Provider Name | Abraham Kuranga |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821418237 PECOS PAC ID: 0749579878 Enrollment ID: I20181023002662 |
Provider Name | Jennifer L Phelps |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548669112 PECOS PAC ID: 2264650340 Enrollment ID: I20181107000540 |
Provider Name | Jenniffer Lee Price |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881160885 PECOS PAC ID: 7416841655 Enrollment ID: I20181204000811 |
Provider Name | Julie Marie Brewster |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962970129 PECOS PAC ID: 5799028825 Enrollment ID: I20190513002548 |
Provider Name | Zachary L Kyle |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1104294180 PECOS PAC ID: 4789919176 Enrollment ID: I20190708001034 |
Provider Name | Nathan Call |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629636089 PECOS PAC ID: 3072849595 Enrollment ID: I20190722002400 |
Provider Name | Deanna Forsythe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548828338 PECOS PAC ID: 9830425974 Enrollment ID: I20190726000247 |
Provider Name | Kara E Younce |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245795913 PECOS PAC ID: 5092041137 Enrollment ID: I20190726000320 |
Provider Name | Todd Shaw |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558923417 PECOS PAC ID: 2062742596 Enrollment ID: I20190926001855 |
Provider Name | Casey Peterson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154970879 PECOS PAC ID: 4880925619 Enrollment ID: I20191009002586 |
Provider Name | Elizabeth Ann Adams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164847372 PECOS PAC ID: 8729393160 Enrollment ID: I20191115001363 |
Provider Name | Cortney Wilcox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063954451 PECOS PAC ID: 6800136508 Enrollment ID: I20191118000112 |
Provider Name | Chanel Jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013536358 PECOS PAC ID: 1850721465 Enrollment ID: I20200422003195 |
Provider Name | David M Jette |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962036715 PECOS PAC ID: 2466883376 Enrollment ID: I20200508002542 |
Provider Name | Madalene Beckner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700408648 PECOS PAC ID: 2163843343 Enrollment ID: I20200526000132 |
Provider Name | Devin Shafer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285252205 PECOS PAC ID: 7113342064 Enrollment ID: I20200817001750 |
Provider Name | Bernadette Gray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497370019 PECOS PAC ID: 0244657419 Enrollment ID: I20200902001755 |
Provider Name | Corinne Rhoades |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649608639 PECOS PAC ID: 6204256886 Enrollment ID: I20201020002915 |
Provider Name | Bambi Michelle Cardinal |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952915951 PECOS PAC ID: 7911318027 Enrollment ID: I20201120002233 |
Provider Name | Kaitlin Overfield |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508468133 PECOS PAC ID: 8921411430 Enrollment ID: I20201230000356 |
Provider Name | Timothy S Mcafee |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548851785 PECOS PAC ID: 6406264753 Enrollment ID: I20210426002532 |
Provider Name | Brandy Lynn Baker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487221859 PECOS PAC ID: 8022412857 Enrollment ID: I20210802001173 |
Provider Name | Catherine Flem |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699388942 PECOS PAC ID: 6002229325 Enrollment ID: I20210907002085 |
Provider Name | Camilla Wallace |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851572606 PECOS PAC ID: 6901202050 Enrollment ID: I20210915000893 |
Provider Name | Josephine Mwachande |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073184206 PECOS PAC ID: 0143618645 Enrollment ID: I20211103000906 |
Provider Name | Jared Caudill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790454650 PECOS PAC ID: 4284023086 Enrollment ID: I20211117001103 |
Provider Name | Courtenay Ann Miller |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1922644053 PECOS PAC ID: 2365876208 Enrollment ID: I20211129000335 |
Provider Name | Kaylyn Cooke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750968160 PECOS PAC ID: 4284025289 Enrollment ID: I20211230001290 |
Provider Name | Jenille L. Klopfenstein |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215599758 PECOS PAC ID: 2365835113 Enrollment ID: I20220131001988 |
Provider Name | Rebecca Land |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790325504 PECOS PAC ID: 0547655664 Enrollment ID: I20220328000213 |
Provider Name | Lindsey Klopfenstein |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447911615 PECOS PAC ID: 3577959782 Enrollment ID: I20220414001830 |
Provider Name | Leann J Mayer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114678869 PECOS PAC ID: 7618356932 Enrollment ID: I20220616001907 |
Provider Name | Paige Katherine Walker |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1700419744 PECOS PAC ID: 8820478738 Enrollment ID: I20220709000897 |
Provider Name | Jessica Wahl |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457028565 PECOS PAC ID: 5991186942 Enrollment ID: I20220721002430 |
Provider Name | Cassandra Lynn Vanmeter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770218299 PECOS PAC ID: 2769867308 Enrollment ID: I20220916002419 |
Provider Name | Jennifer Williams |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1497917603 PECOS PAC ID: 6800262056 Enrollment ID: I20221013001524 |
Provider Name | Tabitha Alford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316394406 PECOS PAC ID: 4789977000 Enrollment ID: I20221031001110 |
Provider Name | Sarah Poag |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982325676 PECOS PAC ID: 6406223395 Enrollment ID: I20221107000813 |
Provider Name | Carissa Vancamp |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346957917 PECOS PAC ID: 2365811569 Enrollment ID: I20221209002500 |
Provider Name | Mindy A Scott |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063122273 PECOS PAC ID: 9335519388 Enrollment ID: I20230109000385 |
Provider Name | Zeinab Hassan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053024182 PECOS PAC ID: 4981075215 Enrollment ID: I20230125001313 |
Provider Name | Elizabeth Low |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376288894 PECOS PAC ID: 9830577790 Enrollment ID: I20230303002060 |
Provider Name | Ton Le |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225689359 PECOS PAC ID: 9133598600 Enrollment ID: I20230307001180 |
Provider Name | Douglas Mukorombindo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326764127 PECOS PAC ID: 8527431865 Enrollment ID: I20230307001255 |
Provider Name | Robert Ritter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093421349 PECOS PAC ID: 4486028149 Enrollment ID: I20230320001430 |
Provider Name | Makulah Schweiger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487006987 PECOS PAC ID: 8224316609 Enrollment ID: I20230328001036 |
Provider Name | Teresa Cating |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508281593 PECOS PAC ID: 8123244084 Enrollment ID: I20230404001013 |
Provider Name | Cortney Kulers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841700341 PECOS PAC ID: 7214299312 Enrollment ID: I20230417000189 |
Provider Name | Ashleigh Denise Warburton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679274906 PECOS PAC ID: 3072988484 Enrollment ID: I20230417000357 |
Provider Name | Marlene Whaley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609205442 PECOS PAC ID: 1254569643 Enrollment ID: I20230512000203 |
Provider Name | Carissa Marie Kelly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20230517002223 |
Provider Name | Elizabeth Barnhill-blackwell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386275006 PECOS PAC ID: 1850721374 Enrollment ID: I20230612000774 |
Provider Name | Pamela Nubong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891436481 PECOS PAC ID: 3779942925 Enrollment ID: I20230706000528 |
Provider Name | Sonya Taylor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770267551 PECOS PAC ID: 1052771524 Enrollment ID: I20230714003069 |
Provider Name | Ivey Thompson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063932473 PECOS PAC ID: 8729205505 Enrollment ID: I20230721001815 |
Provider Name | Chendra Dikko |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669134847 PECOS PAC ID: 5092108738 Enrollment ID: I20230721002186 |
Provider Name | Jodi Guy |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104411875 PECOS PAC ID: 7214345289 Enrollment ID: I20230804002241 |
Provider Name | Molly Salmonsen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356943799 PECOS PAC ID: 1254745367 Enrollment ID: I20230923000271 |
Provider Name | Sheena Steele |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013412170 PECOS PAC ID: 9830452226 Enrollment ID: I20231030001104 |
Provider Name | Sushila Thapa |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801679543 PECOS PAC ID: 3971959693 Enrollment ID: I20231031003211 |
Provider Name | Ernesto Nillar-fonseca |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1508003195 PECOS PAC ID: 9931592086 Enrollment ID: I20231108000231 |
Provider Name | Sara Hatfield |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831879055 PECOS PAC ID: 1355703950 Enrollment ID: I20231108003518 |
Provider Name | Stephanie Marie Yeakle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558142323 PECOS PAC ID: 3779931936 Enrollment ID: I20231128003072 |
Provider Name | Margaret Miru |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326827916 PECOS PAC ID: 0446609259 Enrollment ID: I20231205002868 |
Provider Name | Adam Culbertson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245849835 PECOS PAC ID: 5799104154 Enrollment ID: I20231205003636 |
Provider Name | Amber Adcock |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629422886 PECOS PAC ID: 7214225341 Enrollment ID: I20240109002284 |
Provider Name | Rhonda Hoch |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144769936 PECOS PAC ID: 4284087420 Enrollment ID: I20240124002475 |
Provider Name | Haley Rush |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1225807993 PECOS PAC ID: 3274986419 Enrollment ID: I20240124002508 |
Provider Name | Marion Nyaguthii Nganga |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912785643 PECOS PAC ID: 4688804925 Enrollment ID: I20240125002517 |
Provider Name | Cheryl Lynn Morris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942061262 PECOS PAC ID: 7719320845 Enrollment ID: I20240206002419 |
Provider Name | Bruce Holder |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1639701279 PECOS PAC ID: 8820433402 Enrollment ID: I20240305003614 |
Provider Name | Chelsey Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699330217 PECOS PAC ID: 0345574273 Enrollment ID: I20240312000410 |
Provider Name | Mary Nguru |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225894454 PECOS PAC ID: 1759728678 Enrollment ID: I20240327000530 |
Provider Name | Victor Zindoga |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871350744 PECOS PAC ID: 3173960028 Enrollment ID: I20240327001492 |
Provider Name | Jessica Diane Sajdyk |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558124180 PECOS PAC ID: 3072952720 Enrollment ID: I20240415003154 |
Provider Name | Jodi Keith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649981671 PECOS PAC ID: 4587034038 Enrollment ID: I20240416002745 |
Provider Name | Dennis Scott Sipe |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1871731711 PECOS PAC ID: 1254771074 Enrollment ID: I20240426002414 |
Provider Name | Brenda L Goetz |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1750481222 PECOS PAC ID: 9739366147 Enrollment ID: I20240507001980 |
Provider Name | Amanda Stagg |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891561585 PECOS PAC ID: 4486091162 Enrollment ID: I20240507003025 |
Provider Name | Lorrie Nein |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356044713 PECOS PAC ID: 7214396084 Enrollment ID: I20240507003329 |
Provider Name | Allison Devaney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194581967 PECOS PAC ID: 1850733650 Enrollment ID: I20240524001177 |
Provider Name | Tracey Dapper |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417347279 PECOS PAC ID: 5698092336 Enrollment ID: I20240607001120 |
Prometheus Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10214 Chestnut Plaza Dr, Suite 130, Fort Wayne, IN 46814 Phone: 260-409-8188 | |
Christina Stapleton, L.l.c Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10315 Dawsons Creek Blvd # 12, Fort Wayne, IN 46825 Phone: 260-387-6340 | |
Oaktree Guidance & Wellness Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 Phone: 260-570-4515 Fax: 260-209-0762 | |
Courageous Healing Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2013 S Anthony Blvd, Fort Wayne, IN 46803 Phone: 260-417-4801 | |
Raj Clinics Professional Services Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Airport North Office Park, Fort Wayne, IN 46825 Phone: 574-732-1166 Fax: 574-753-4117 | |
Sharon Mowrer Counseling And Consulting Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Magnavox Way, Suite 120, Fort Wayne, IN 46804 Phone: 260-760-8645 | |
A.w. Holdings, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3900 Hursh Rd, Fort Wayne, IN 46845 Phone: 260-637-3608 |