DR. JANETTE LYNN HOLUB (NPI# 1265609879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265609879 |
| Entity Type | Individual |
| Full Name | DR. JANETTE LYNN HOLUB |
| Credential | MD, MPH |
| Practice Address |
11141 Parkview Plaza Dr Suite 305 Fort Wayne IN 46845-1713 |
| Mailing Address |
1234 E Dupont Rd Suite 1 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2602668900 |
| Practice Fax Number | 2602668935 |
| Mailing Telephone | 2603739700 |
| Mailing Fax Number | 2603739740 |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2015-11-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036121113 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
01075879A | IN | Allopathic & Osteopathic Physicians |
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
51715 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
11141 PARKVIEW PLAZA DR SUITE 305 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811999840 | William R Cast | Otolaryngology | 11141 Parkview Plaza Dr, Suite 210, Fort Wayne, IN 46845-1701 | 2005-08-10 |
| 1891236568 | Emily Kyburz | Dietitian, Registered | 11141 Parkview Plaza Dr, Ste 305b, Fort Wayne, IN 46845-1713 | 2017-03-15 |
| 1629440193 | Sarah Weaver | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 210, Fort Wayne, IN 46845-1713 | 2015-10-23 |
| 1730563255 | Chelsea Rentschler | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2015-07-14 |
| 1699171975 | Taylor Hill | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-11-13 |
| 1174926919 | Debra Brice | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-10-08 |
| 1548661184 | Beth Burns | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-09-15 |
| 1346641644 | Grant Paul Tyler | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2014-09-06 |
| 1417383217 | Elizabeth A Daseler | Nurse Practitioner | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2013-09-25 |
| 1689922403 | Amanda Michelle Bolin | Dietitian, Registered | 11141 Parkview Plaza Dr, Suite 210, Fort Wayne, IN 46845-1713 | 2012-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528357118 | Cecivon Arreola-garcia | Surgery | 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 | 2011-04-04 |
| 1306098439 | Constantine G Saites | Surgery | 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 | 2008-10-21 |
| 1669576997 | Parkview Hospital, Inc. | Surgery | 11109 Parkview Plaza Dr, Trauma Unit, Fort Wayne, IN 46845-1701 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881030450 | Thaddeus Joseph Puzio | Surgery | 1801 N Senate Blvd Dept Surgery, Indianapolis, IN 46202 | 2013-05-22 |
| 1700324720 | Brittlebank Acute Trauma Specialists LLC | Surgery | 3901 S 7th St, Terre Haute, IN 47802-5709 | 2017-02-09 |
| 1295185858 | Wabash Valley Surgical Associates LLC | Surgery | 3901 S 7th St, Terre Haute, IN 47802-5709 | 2016-06-15 |
| 1912305699 | Baikal Surgical Specialists LLC | Surgery | 3901 S 7th St, Terre Haute, IN 47802-5709 | 2014-12-12 |
| 1487717120 | John Matthew Radosevich | Surgery | 807 Glendale Blvd, Valparaiso, IN 46383-3718 | 2006-12-17 |
| City | FORT WAYNE |
| Zip Code | 46845 |
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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.