EVAN JAY DETWEILER (NPI# 1255678074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255678074 |
| Entity Type | Individual |
| Full Name | EVAN JAY DETWEILER |
| Credential | MBA, OT |
| Practice Address |
611 W County Line Rd S Fort Wayne IN 46814-7592 |
| Mailing Address |
2222 Sullivan Trl Easton PA 18040-7958 |
| Practice Telephone | 2606251445 |
| Practice Fax Number | 2606251445 |
| Mailing Telephone | 8009449782 |
| Mailing Fax Number | 6104382046 |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 31002343A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
611 W COUNTY LINE RD S |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46814-7592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013253293 | Paxxon Healthcare Services LLC | Occupational Therapist | 611 W County Line Rd S, Fort Wayne, IN 46814-7592 | 2012-12-17 |
| 1831652957 | Hearth At Sycamore Village | Assisted Living Facility | 611 W County Line Rd S, Fort Wayne, IN 46814-7592 | 2019-04-08 |
| 1114353620 | Karen Elizabeth Wardwell | Physical Therapist | 611 W County Line Rd S, Fort Wayne, IN 46814-7592 | 2013-09-17 |
| 1336571488 | Allison Lucy Shuler | Occupational Therapist | 611 W County Line Rd S, Fort Wayne, IN 46814-7592 | 2013-07-31 |
| 1518204338 | Jack Kevin Shumaker | Occupational Therapist | 611 W County Line Rd S, Fort Wayne, IN 46814-7592 | 2013-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295256907 | Kimberly Ann Bailey | Social Worker | 5310 Merchandise Dr., Fort Wayne, IN 46814 | 2017-07-03 |
| 1821229998 | Back In Action Chiropractic | Chiropractor | 10443 Llinois Road, Fort Wayne, IN 46814 | 2009-08-06 |
| 1376789420 | Richard Frederick Fox | Radiology | 6226 Devils Hollow Rd., Fort Wayne, IN 46814 | 2008-12-19 |
| 1225287998 | George W. Bowers | Urology | 12002 Haddington Court, Fort Wayne, IN 46814 | 2008-09-17 |
| 1588831986 | Xue Zhang | Family Medicine | 10515 Illimois Rd, Fort Wayne, IN 46814 | 2008-05-14 |
| 1245449172 | Charles S Lindzy | Anesthesiology | 14104 Peddlers Ford, Fort Wayne, IN 46814 | 2007-05-21 |
| 1043338999 | Aboite Township Fire Dept In | Ambulance | 11321 Aboite Center Rd, Fort Wayne, IN 46814 | 2007-03-27 |
| 1588748206 | Lisa Renee Vachon | Chiropractor | 971 Chestnut Hills Pkwy, Ft Wayne, IN 46814 | 2006-10-25 |
| 1962586685 | Daniel Vern Velliquette | Chiropractor | 971 Chestnut Hills Parkway, Fort Wayne, IN 46814 | 2006-10-25 |
| 1336255801 | Erica L Walworth | Marriage & Family Therapist | 412 S Scott Rd, Fort Wayne, IN 46814 | 2006-08-21 |
| Find all providers in zip 46814 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134746209 | Laurel Schroeder | Occupational Therapist | 1726 Bluffton Rd, Fort Wayne, IN 46809-1305 | 2020-07-06 |
| 1831715481 | Hannah Saprid Cho | Occupational Therapist | 3024 Emerald Lake Dr, Fort Wayne, IN 46804-2406 | 2020-06-19 |
| 1811510464 | Carmen Rosales | Occupational Therapist | 10331 Copper Tree Pl, Fort Wayne, IN 46804-4284 | 2020-05-18 |
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1073074571 | Melanie Blanchard | Occupational Therapist | 2626 Saint Joe Center Rd, Fort Wayne, IN 46825-5042 | 2019-03-27 |
| 1669939864 | Kristen Macy | Occupational Therapist | 201 E Rudisill Blvd Ste 301, Fort Wayne, IN 46806-1756 | 2019-02-23 |
| 1841769270 | Brian Bernard Conaway | Occupational Therapist | 7125 S Hanna St, Fort Wayne, IN 46816 | 2018-11-14 |
| 1073041901 | Julie Replogle | Occupational Therapist | 409 E Cook Rd Ste 100, Fort Wayne, IN 46825-3656 | 2017-05-23 |
| 1073998530 | Joshua Michael Oesterling | Occupational Therapist | 3030 Lake Ave Ste 8, Fort Wayne, IN 46805-5428 | 2015-07-27 |
| 1881072916 | Diane Lynn Zinn | Occupational Therapist | 8300 Maysville Rd, Fort Wayne, IN 46815-6619 | 2015-05-08 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46814 |
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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.