LARRY BLEDSOE (NPI# 1396763702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396763702 |
| Entity Type | Individual |
| Full Name | LARRY BLEDSOE |
| Credential | MD |
| Practice Address |
620 W Berry St Fort Wayne IN 46802-2106 |
| Practice Telephone | 2604246311 |
| Practice Fax Number | 2604246311 |
| Mailing Telephone | 2604246311 |
| Mailing Fax Number | 2604246311 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-09-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01028106 | IN | Allopathic & Osteopathic Physicians |
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
01028106 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100061080A | 05 |
| Street Address |
620 W BERRY ST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46802-2106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084416 | Renaissance Counseling Center,llc | Community/Behavioral Health | 1210 Guthrie St, Fort Wayne, IN 46802 | 2020-05-14 |
| 1699260182 | Tina Huffman Counseling Services LLC | Clinic/Center | 2323 111 W. Berry St., Fort Wayne, IN 46802 | 2018-06-27 |
| 1669879664 | Neighborhood Health Clinics, Inc | Clinic/Center | 1721 S Calhoun St, Fort Wayne, IN 46802 | 2014-11-20 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1174899405 | Hearcare Connection, Inc. | Audiologist | 130 W Main St Ste 150, Fort Wayne, IN 46802 | 2012-03-30 |
| 1801114533 | Hoosier Sports & Chiropractic LLC | Chiropractor | 122 W Wayne Street, Fort Wayne, IN 46802 | 2010-05-05 |
| 1891912523 | Krista Lohmar | Speech-Language Pathologist | 3340 North Washington Road, Ft. Wayne, IL 46802 | 2007-04-20 |
| 1811047608 | Catholic Charities of The Diocese of Fort Wayne-south Bend, Inc. | Counselor | 915 South Clinton, Fort Wayne, IN 46802 | 2007-01-12 |
| 1548323801 | Clifford T Salk | Dentist | 122 W Washington Blvd, Fort Wayne, IN 46802 | 2006-12-18 |
| 1720155492 | Kristina Wise | Social Worker | 203 W Wayne St Ste 317, Fort Wayne, IN 46802 | 2006-11-29 |
| Find all providers in zip 46802 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053709402 | Sheila Falloon Md LLC | Internal Medicine | 6232 Shady Creek Ct, Fort Wayne, IN 46814-3298 | 2015-01-07 |
| 1043644354 | Fort Wayne Medical Clinic PC | Internal Medicine | 3537 N Anthony Blvd Ste C, Fort Wayne, IN 46805-1423 | 2013-08-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1215377296 | Ram Kishun Verma | Internal Medicine | 1234 E Dupont Rd Ste 5, Fort Wayne, IN 46825 | 2013-07-05 |
| 1871840934 | Amabel Pia A Lapuebla | Internal Medicine | 11104 Parkview Circle Dr Ste 440, Fort Wayne, IN 46845-1672 | 2012-08-08 |
| 1538432141 | C & D Healthcare Services, LLC | Internal Medicine | 327 E Wayne St, Fort Wayne, IN 46802-2753 | 2012-02-13 |
| 1407141500 | Patrick Joseph Wise | Internal Medicine | 6435 W Jefferson Blvd, Fort Wayne, IN 46804-6203 | 2011-06-16 |
| 1235438185 | Blue Crescent Blue Star Medical of Indiana, Inc | Internal Medicine | 2326 Hobson Rd, Fort Wayne, IN 46805-2916 | 2011-03-17 |
| 1336441948 | Vishaal Veerula | Internal Medicine | 7802 W. Jefferson Blvd. #b, Fort Wayne, IN 46804 | 2010-12-02 |
| 1609019900 | Srisai P C | Internal Medicine | 7972 West Jefferson Blvd, Suite A, Fort Wayne, IN 46804-4140 | 2009-04-16 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46802 |
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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.