JEREMY THAIN (NPI# 1245642461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245642461 |
| Entity Type | Individual |
| Full Name | JEREMY THAIN |
| Credential | R.PH., BS |
| Practice Address |
5909 Illinois Rd Fort Wayne IN 46804 |
| Practice Telephone | 2604343910 |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2014-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835N1003X |
Pharmacist Specialization: Nutrition Support |
26015798A | IN | Pharmacy Service Providers |
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
26015798A | IN | Pharmacy Service Providers |
| Street Address |
5909 ILLINOIS RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326063298 | Arcadia Healthcare Solutions, Inc. | Nursing Care | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2006-07-13 |
| 1649702176 | Chris Johnson | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2017-04-03 |
| 1003228974 | Margaret Mcdonald | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2014-05-27 |
| 1598177875 | Stephen Saharian | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2014-05-21 |
| 1336550789 | Steven Becker | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2014-05-19 |
| 1659619427 | Usv Optical Inc. | Technician/Technologist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2013-01-29 |
| 1841560646 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2012-01-10 |
| 1932325644 | Felicia Anne Colclesser | Nurse Practitioner | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2007-04-18 |
| 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 | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033259197 | V E Butler and Associates PC | Pharmacist | 2700 S. Lafayette St, Communitycare Pharmacy, Fort Wayne, IN 46806-1100 | 2007-02-07 |
| 1669951877 | Kristen Elizabeth Christman | Pharmacist | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2018-08-08 |
| 1255820163 | Timothy Lee Johnston | Pharmacist | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2018-05-07 |
| 1134618150 | Elizabeth Meisberger | Pharmacist | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2018-05-04 |
| 1649702176 | Chris Johnson | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2017-04-03 |
| 1619359981 | Andrew Jason Bergman | Pharmacist | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2015-06-23 |
| 1003228974 | Margaret Mcdonald | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2014-05-27 |
| 1487066676 | Gerald Ellis | Pharmacist | 10301 E State Road 37, Fort Wayne, IN 46835-9591 | 2014-05-22 |
| 1588076863 | Ryan Ades | Pharmacist | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2014-05-21 |
| 1619389095 | John Phillip Purvis | Pharmacist | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2014-05-20 |
| Find all providers in FORT WAYNE | ||||
| 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.