REGEN MED OF INDIANA LLC (NPI# 1104395680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104395680 |
| Entity Type | Organization |
| Organization Name | REGEN MED OF INDIANA LLC |
| Practice Address |
5931 Stoney Creek Dr Fort Wayne IN 46825-4401 |
| Practice Telephone | 2604822206 |
| Practice Fax Number | 2604833964 |
| Mailing Telephone | 2604822206 |
| Mailing Fax Number | 2604833964 |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |
| Authorized Official Name | TONNA B. CHALFANT (MANAGER) |
| Authorized Official Telephone | 2604822206 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
5931 STONEY CREEK DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598863920 | David Brian Chalfant | Chiropractor | 5931 Stoney Creek Dr, Fort Wayne, IN 46825-4401 | 2006-09-20 |
| 1770738288 | David B. Chalfant PC | Clinic/Center | 5931 Stoney Creek Dr, Fort Wayne, IN 46825-4401 | 2008-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053946293 | Youhealth, Inc. | General Practice | 9515 Ledge Wood Ct, Fort Wayne, IN 46804-4701 | 2020-03-09 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1871074732 | Healthy Schools Indiana LLC | General Practice | 6605 E State Blvd Ste 9, Fort Wayne, IN 46815-7036 | 2018-08-28 |
| 1801138102 | Family Health Practitioners, LLC | General Practice | 909 River Oak Run, Fort Wayne, IN 46804-3543 | 2013-03-25 |
| 1679836910 | Innovative Professional Service LLC | General Practice | 3464 Stellhorn Rd, Fort Wayne, IN 46815-4630 | 2012-06-21 |
| 1003134123 | Aptcare In 1 | General Practice | 11718 Woodstream Ridge Ct, Fort Wayne, IN 46845-1908 | 2010-05-13 |
| 1750743381 | Aptcare LLC | General Practice | 11718 Woodstream Ridge Ct, Fort Wayne, IN 46845-1908 | 2016-03-23 |
| 1619044047 | Robert L Arnold Dds Inc | General Practice | 5800 Fairfield Ave, Suite 220, Fort Wayne, IN 46807-3437 | 2006-11-29 |
| 1083726848 | Robert L Arnold | General Practice | 5800 Fairfield Ave, Suite 220, Fort Wayne, IN 46807-3437 | 2006-08-31 |
| 1518909985 | Qhg of Fort Wayne Company LLC | General Practice | 7333 W Jefferson Blvd, Fort Wayne, IN 46804-6280 | 2006-06-12 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on REGEN MED OF INDIANA 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.