MARTHA VERGARA (NPI# 1649701996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649701996 |
| Entity Type | Individual |
| Full Name | MARTHA VERGARA |
| Practice Address |
11104 Parkview Circle Dr Ste 310 Fort Wayne IN 46845-1672 |
| Mailing Address |
3926 New Vision Dr Fort Wayne IN 46845-1712 |
| Practice Telephone | 2602665230 |
| Mailing Telephone | 2602668210 |
| Mailing Fax Number | 2604585636 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71007045A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285114 | Martha Marlene Vergara | Student in an Organized Health Care Education/Training Program | 506 W Jackman St, Lancaster, CA 93534-2531 | 2019-09-23 |
| Street Address |
11104 PARKVIEW CIRCLE DR STE 310 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285633552 | Leor David Roubein | Internal Medicine | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1672 | 2005-07-19 |
| 1689280356 | Tabatha North | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2020-09-18 |
| 1578128575 | Erin L Mctague | Physician Assistant | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2019-05-06 |
| 1184187999 | Christina M Weiss | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2019-04-09 |
| 1104389121 | Amanda R Follrod | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2019-04-08 |
| 1629572094 | Taylor Pinney | Physician Assistant | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845 | 2018-03-21 |
| 1477055804 | Stacie Stauffer | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2018-03-01 |
| 1053827469 | Megan E Daniels | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2017-12-20 |
| 1356897383 | Abby J Emerick | Nurse Practitioner | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2016-08-30 |
| 1114379732 | Meagan K O'brien | Physician Assistant | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845 | 2016-07-07 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566397 | Stacey Renee Pulver | Nurse Practitioner | 13134 Hollow Oak Rd, Fort Wayne, IN 46845-2327 | 2020-10-22 |
| 1649878554 | Heather Ormiston-leclear | Nurse Practitioner | 3800 N Anthony Blvd # Cc1335, Fort Wayne, IN 46805-1430 | 2020-10-13 |
| 1669081618 | Carly Ann Nahrwold | Nurse Practitioner | 7025 Old Trail Rd # 9574, Fort Wayne, IN 46809-2713 | 2020-07-27 |
| 1932725942 | Health Essential LLC | Nurse Practitioner | 3030 Lake Ave Ste 14, Fort Wayne, IN 46805-5428 | 2020-06-25 |
| 1942824842 | Carissa Miller | Nurse Practitioner | 707 Rollingwood Ln, Fort Wayne, IN 46845-1088 | 2020-06-05 |
| 1891329819 | Jasmine Monae Tubbs | Nurse Practitioner | 875 Petal Way, Fort Wayne, IN 46816-8900 | 2020-02-28 |
| 1235780362 | Elizabeth Rose Lichtsinn | Nurse Practitioner | 3919 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-6811 | 2019-09-20 |
| 1033676275 | Amanda Warner | Nurse Practitioner | 2229 Woods Rd, Fort Wayne, IN 46818-9539 | 2019-02-25 |
| 1669940714 | Brookelyn Agler | Nurse Practitioner | Summit Radiology, PC, 5001 Us Highway 30 W, Suite D, Fort Wayne, IN 46818-9701 | 2018-11-07 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on MARTHA VERGARA.
| 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.