MRS. REBECCA MARIE BLUME (NPI# 1679664379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679664379 |
| Entity Type | Individual |
| Full Name | MRS. REBECCA MARIE BLUME |
| Credential | PA-C |
| Practice Address |
3030 Lake Ave Suite 25a Fort Wayne IN 46805-5428 |
| Mailing Address |
18028 Fogel Rd Churubusco IN 46723-9213 |
| Practice Telephone | 2604224096 |
| Practice Fax Number | 2604242551 |
| Mailing Telephone | 2606377537 |
| Mailing Fax Number | 2604242551 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10000655A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3030 LAKE AVE SUITE 25A |
| 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 |
| 1447587696 | Indiana Endocrine Specialist, LLC | Clinic/Center | 3030 Lake Ave, Suite 17, Fort Wayne, IN 46805-5428 | 2009-11-09 |
| 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 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438944 | Erin R Griffin | Physician Assistant | 5621 Woodshire Dr Apt 5, Fort Wayne, IN 46835-2959 | 2020-08-22 |
| 1821608209 | Rebecca Coker | Physician Assistant | 5137 Truemper Way Apt 5, Fort Wayne, IN 46835-3252 | 2020-07-31 |
| 1114536844 | Amanda Kohl | Physician Assistant | 5429 River Run Trl # 5, Fort Wayne, IN 46825-6039 | 2020-07-29 |
| 1538778352 | Kiersten Michelle Coatney | Physician Assistant | 3924 Taylor Rd Apt 65, Fort Wayne, IN 46804-1945 | 2020-07-28 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1972890093 | Megan Bearman | Physician Assistant | 3640 New Vision Dr, Suite A, Fort Wayne, IN 46845-1717 | 2011-07-10 |
| 1114211729 | Joel A Ruetz | Physician Assistant | 7619 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2011-06-01 |
| 1568617256 | Parkview Health System Inc | Physician Assistant | 11104 Parkview Circle Dr Ste 320, Fort Wayne, IN 46845-1733 | 2008-11-21 |
| 1841441805 | Brooke B Kutka | Physician Assistant | 2512 East Dupont Rd, Suite 200, Fort Wayne, IN 46825-1609 | 2008-10-08 |
| 1265688808 | Kali E Veness | Physician Assistant | 2930 Lake Ave, Fort Wayne, IN 46805-5416 | 2008-08-14 |
| Find all providers in FORT WAYNE | ||||
| 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.