INDIANA ENDOCRINE SPECIALIST, LLC (NPI# 1447587696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447587696 |
| Entity Type | Organization |
| Organization Name | INDIANA ENDOCRINE SPECIALIST, LLC |
| Practice Address |
3030 Lake Ave Suite 17 Fort Wayne IN 46805-5428 |
| Practice Telephone | 2604979510 |
| Mailing Telephone | 2604979510 |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2015-10-31 |
| Authorized Official Name | H STEPHEN BEYER (OWNER) |
| Authorized Official Telephone | 2604979510 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Street Address |
3030 LAKE AVE SUITE 17 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-5428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073507745 | Thomas P Van Den Driessche | Family Medicine | 3030 Lake Ave, Suite32, Fort Wayne, IN 46805-5428 | 2005-09-08 |
| 1417494170 | Linzie Tuck | Behavioral Analyst | 3030 Lake Ave, Suite 20, Fort Wayne, IN 46805-5428 | 2017-01-19 |
| 1225204613 | Marilyn Arlene Nathan | Psychologist | 3030 Lake Ave, Fort Wayne, IN 46805-5428 | 2008-05-05 |
| 1538349956 | Thomas P Van Den Driessche | Family Medicine | 3030 Lake Ave, Suite 32, Fort Wayne, IN 46805-5428 | 2007-11-14 |
| 1417156456 | Nora Marie Stewart | Audiologist-Hearing Aid Fitter | 3030 Lake Ave, Suite 23, Fort Wayne, IN 46805-5428 | 2007-07-11 |
| 1093916959 | Little Turtle Pediatrics, P.C. | Pediatrics | 3030 Lake Ave, Suite 10, Fort Wayne, IN 46805-5428 | 2007-05-29 |
| 1780899096 | Michael Joseph Luarde | Dentist | 3030 Lake Ave, Suite 19, Fort Wayne, IN 46805-5428 | 2007-05-11 |
| 1093938102 | Interdisciplinary Diagnostic and Evaluation Center, Inc. | Clinic/Center | 3030 Lake Ave, Suite 7, Fort Wayne, IN 46805-5428 | 2007-04-10 |
| 1790801512 | Pediatric & Adult Allergy Asthma & Immunology Specialists, LLC | Allergy & Immunology | 3030 Lake Ave, Suite 27, Fort Wayne, IN 46805-5428 | 2007-03-22 |
| 1568595999 | Pediatrics Center of Fort Wayne, P.C. | Pediatrics | 3030 Lake Ave, #25a, Fort Wayne, IN 46805-5428 | 2007-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1174861454 | Indiana Plastic Surgery Center, PC | Clinic/Center | 10020 Dupont Circle Ct, Suite 100, Fort Wayne, IN 46825-1620 | 2013-01-22 |
| 1730359308 | Miskelly Chiropractic Center P C | Clinic/Center | 2811 Lower Huntington Rd, Fort Wayne, IN 46809-2616 | 2008-03-10 |
| 1811941024 | Northeast Obstetrics & Gynecology, LLC | Clinic/Center | 11123 Parkview Plaza Dr, Suite 101, Fort Wayne, IN 46845-1707 | 2006-05-20 |
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| 1902429251 | Telacare Health Solutions, LLC | Clinic/Center | 11650 Olio Rd Ste 1000-172, Fishers, IN 46037-7619 | 2020-05-21 |
| 1275001489 | Decatur County Memorial Hospital | Clinic/Center | 955 N Michigan Ave Ste 2, Greensburg, IN 47240-1487 | 2018-11-06 |
| 1285164509 | Better Quality of Life Care Md, PC | Clinic/Center | 8334 Beech Ave, Munster, IN 46321-1440 | 2017-06-19 |
| 1639622236 | Fordem Health, LLC | Clinic/Center | 1313 Park Dr, Munster, IN 46321-2634 | 2016-07-31 |
| 1447619747 | Sanford Dermatology | Clinic/Center | 400 W Green Meadows Dr Ste 110, Greenfield, IN 46140-3205 | 2016-02-15 |
| 1306222757 | Midwest Wellness LLC | Clinic/Center | 6822 E 82nd St Ste 310, Indianapolis, IN 46250-1677 | 2015-08-08 |
| 1861757023 | Integrative Therapeutics LLC | Clinic/Center | 11074 Woods Bay Ln, Indianapolis, IN 46236-9020 | 2012-07-12 |
| 1093953234 | Wabash Valley Infectious Diseases Clinic LLC | Clinic/Center | 2112 S 3rd St, Terre Haute, IN 47802-3045 | 2009-01-27 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
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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.