LAFAYETTE FOOT & ANKLE LLC (NPI# 1003193814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003193814 |
| Entity Type | Organization |
| Organization Name | LAFAYETTE FOOT & ANKLE LLC |
| Practice Address |
2700 Lafayette St Suite 100 Fort Wayne IN 46806-1100 |
| Practice Telephone | 2604589953 |
| Practice Fax Number | 2604589238 |
| Mailing Telephone | 2604589953 |
| Mailing Fax Number | 2604589238 |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2016-05-23 |
| Authorized Official Name | DR. BENNY FAIR JR. (CEO) |
| Authorized Official Telephone | 2604589953 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100082090A | 05 |
| Street Address |
2700 LAFAYETTE ST SUITE 100 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46806-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053376186 | Rebecca Konkin | Nurse Practitioner | 2700 Lafayette St, Ste B-10, Fort Wayne, IN 46806-1100 | 2006-04-20 |
| 1316556848 | Alliance Health Centers, Inc. | Nurse Practitioner | 2700 Lafayette St, Fort Wayne, IN 46806-1100 | 2020-07-30 |
| 1164073557 | Kelly Wakefield | Nurse Practitioner | 2700 Lafayette St, Fort Wayne, IN 46806-1100 | 2019-09-26 |
| 1295838365 | Benny Fair Jr. | Podiatrist | 2700 Lafayette St, Suite 120, Fort Wayne, IN 46806-1100 | 2006-09-06 |
| 1053377606 | Jennifer Shambaugh | Nurse Practitioner | 2700 Lafayette St, Ste B-10, Fort Wayne, IN 46806-1100 | 2006-04-24 |
| 1740246651 | Sharon Heaton | Nurse Practitioner | 2700 Lafayette St, Ste 110, Fort Wayne, IN 46806-1100 | 2006-04-21 |
| 1386600120 | Rachael F. Rogers | Physician Assistant | 2700 Lafayette St, Ste 110, Fort Wayne, IN 46806-1100 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841574829 | Daniel E Purvis Jr. | Pharmacist | 222 E Pettit Avenue, Fort Wayne, IN 46806 | 2011-10-07 |
| 1558645754 | Logan M Franke | Pharmacist | 222 E Pettit Ave, Fort Wayne, IN 46806 | 2011-10-06 |
| 1356513725 | Seazoned Med Transportation Service | Non-emergency Medical Transport (VAN) | 2809 Smith Street, Fort Wayne, IN 46806 | 2008-03-26 |
| 1376711267 | Hector F Perez Md PC | Family Medicine | 5717 So Anthony, Ste 500, Fort Wayne, IN 46806 | 2008-02-14 |
| 1326249376 | Purdue University | Dentist | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-05-29 |
| 1174657480 | Robert Anthony Ford | Case Manager/Care Coordinator | 525 Oxford St., Fort Wayne, IN 46806 | 2007-03-16 |
| 1508069972 | Indiana University | Clinic/Center | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-06-06 |
| 1669622403 | Sally J Hartman | Nurse Practitioner | 2700 S Lafayette St, Suite 200, Fort Wayne, IN 46806-1100 | 2008-09-30 |
| 1003099441 | Lafayette Foot and Ankle Clinic | Podiatrist | 2700 Lafayette St Ste 230, Fort Wayne, IN 46806-1100 | 2007-12-07 |
| 1033259197 | V E Butler and Associates PC | Pharmacist | 2700 S. Lafayette St, Communitycare Pharmacy, Fort Wayne, IN 46806-1100 | 2007-02-07 |
| Find all providers in zip 46806 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417337353 | Hazim Ibrahim | Podiatrist | 7527 Thoroughbred Dr Apt 3d, Fort Wayne, IN 46804 | 2015-06-05 |
| 1760683593 | Toes R Us, Inc. | Podiatrist | 6200 Bluffton Rd, Fort Wayne, IN 46809-2260 | 2007-05-30 |
| 1871605147 | Dennis John Chubinski | Podiatrist | 8028 Carnegie Blvd., 400, Fort Wayne, IN 46804-5788 | 2006-08-31 |
| 1114956844 | David K Wysong | Podiatrist | 3012 E State Blvd, Fort Wayne, IN 46805-4737 | 2006-07-03 |
| 1235182643 | Richard M. Hilker, Dpm, P.C. | Podiatrist | 10323 Dawsons Creek Blvd, Bldg. 10-c, Fort Wayne, IN 46825-1910 | 2006-05-18 |
| 1134104474 | Lynn H Stafford | Podiatrist | 7559 W Jefferson Blvd, Fort Wayne, IN 46804-4131 | 2005-12-09 |
| 1487637377 | Richard M Hilker | Podiatrist | 10323 Dawsons Creek, Bldg 10 C, Fort Wayne, IN 46825-1910 | 2005-11-23 |
| 1508867177 | Gary Michael Torkeo | Podiatrist | 4011 W Jefferson Blvd, Suite 175, Fort Wayne, IN 46804-6853 | 2005-08-09 |
| 1346247061 | Michael Steven Worpell | Podiatrist | 1234 E Dupont Rd, 2 1, Fort Wayne, IN 46825-1545 | 2005-07-07 |
| 1760486393 | Lincoln Pedic Clinic, Inc. | Podiatrist | 12311 Autumn Breeze Dr, Fort Wayne, IN 46845-9111 | 2005-06-10 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46806 |
Please comment or provide details below to improve the information on LAFAYETTE FOOT & ANKLE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.