JAY FAWVER (NPI# 1164457404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164457404 |
Entity Type | Individual |
Full Name | JAY FAWVER |
Credential | MD |
Practice Address |
6920 Pointe Inverness Way #250 Fort Wayne IN 46804-7926 |
Mailing Address |
3926 New Vision Dr Suite 1 Fort Wayne IN 46845-1712 |
Practice Telephone | 2604364060 |
Practice Fax Number | 2604365713 |
Mailing Telephone | 2602668210 |
Mailing Fax Number | 2604585636 |
Enumeration Date | 2006-07-12 |
Last Update Date | 2017-02-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
01032403A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | ANTHEM BLUE CROSS | 000000490037 | 01 |
Street Address |
6920 POINTE INVERNESS WAY #250 |
City | FORT WAYNE |
State | IN |
Zip Code | 46804-7926 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679549034 | Veronica A Philbin | Clinical Nurse Specialist | 6920 Pointe Inverness Way, #250, Fort Wayne, IN 46804-7926 | 2006-02-27 |
1235587361 | Joey Dehoff | Nurse Practitioner | 6920 Pointe Inverness Way, Suite 250, Fort Wayne, IN 46804-7938 | 2016-05-31 |
1174908719 | Gloria Gaubatz | Nurse Practitioner | 6920 Pointe Inverness Way, Suite 250, Fort Wayne, IN 46804-7938 | 2015-07-24 |
1750722773 | Sara Glassley | Nurse Practitioner | 6920 Pointe Inverness Way, Suite 250, Fort Wayne, IN 46804-7938 | 2013-07-08 |
1043650203 | Jayne S Sloan | Nurse Practitioner | 6920 Pointe Inverness Way, Suite 250, Fort Wayne, IN 46804-7938 | 2013-07-02 |
1306129283 | Laura Folds | Nurse Practitioner | 6920 Pointe Inverness Way, Suite 250, Fort Wayne, IN 46804-7926 | 2011-09-27 |
1720305782 | Jeanette Deeanne Cochran | Nurse Practitioner | 6920 Pointe Inverness Way, Ste 250, Fort Wayne, IN 46804-7938 | 2010-04-29 |
1174536346 | Fawver Waldo Clinic LLP | Clinic/Center | 6920 Pointe Inverness Way, Suite 250, Fort Wayne, IN 46804-7926 | 2006-08-15 |
1578583910 | Psychiatric Innovations PC | Psychiatry & Neurology | 6920 Pointe Inverness Way, #250, Fort Wayne, IN 46804-7926 | 2006-07-20 |
1235164732 | Carlene Mcclurg | Nurse Practitioner | 6920 Pointe Inverness Way, #250, Fort Wayne, IN 46804-7926 | 2006-07-12 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
Find all providers in zip 46804 |
Taxonomy Code | 2084N0600X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Clinical Neurophysiology |
Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821597485 | Advanced Neurology LLC | Psychiatry & Neurology | 1551 Sturdy Rd, Valparaiso, IN 46383-7883 | 2018-02-08 |
1831570019 | Christopher Alexander Croswell | Psychiatry & Neurology | 1050 Reid Pkwy Ste 210, Richmond, IN 47374-1160 | 2015-06-14 |
1083984132 | Franciscan Healthcare -munster | Psychiatry & Neurology | 7847 Calumet Ave, Munster, IN 46321-1213 | 2012-01-06 |
1568651511 | George F Abu-aita Md PC | Psychiatry & Neurology | 200 East 89th Avenue, Suite 3b, Merrillville, IN 46410-7318 | 2007-10-16 |
1710997929 | George F Abu-aita | Psychiatry & Neurology | 200 E 89th Ave, Suite 3b, Merrillville, IN 46410-7318 | 2006-08-09 |
1710969621 | Jitendra N Sharma | Psychiatry & Neurology | 3611 S Reed Rd, Suite 101, Kokomo, IN 46902-3828 | 2005-11-16 |
City | FORT WAYNE |
Zip Code | 46804 |
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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.