JASON T. GAISFORD (NPI# 1679909931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679909931 |
| Entity Type | Individual |
| Full Name | JASON T. GAISFORD |
| Credential | PA-C |
| Practice Address |
1721 Magnavox Way Fort Wayne IN 46804-1537 |
| Mailing Address |
Po Box 670 Huntertown IN 46748-0670 |
| Practice Telephone | 2607483651 |
| Practice Fax Number | 2607483651 |
| Mailing Telephone | 2607483650 |
| Mailing Fax Number | 2607483651 |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2019-08-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10001602A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300006158 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1314 E 7th St Ste 201, Auburn, IN 467062533 | 2607483650 | 2607483651 |
| 2512 E Dupont Rd Ste 200, Fort Wayne, IN 46825 | 2607483650 | 2607483651 |
| 2124 N Biomet Dr, Warsaw, IN 465827858 | 2607483650 | 2607483651 |
| 6811 Lima Rd, Fort Wayne, IN 468181145 | 2607483650 | 2607483651 |
| Street Address |
1721 MAGNAVOX WAY |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-1537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144215153 | Mark A Fisher | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2005-09-15 |
| 1750991147 | Coffman Anesthesiology LLC | Anesthesiology | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2020-07-31 |
| 1821606500 | Makayla Lawson | Nurse Practitioner | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2020-07-17 |
| 1780218115 | Surgery Center of Fort Wayne | Clinic/Center | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2020-02-25 |
| 1689216442 | Karmen Wilson | Registered Nurse | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2019-10-14 |
| 1295207488 | Lacey Michelle Harvey | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2018-12-28 |
| 1982061701 | Jonathan Notelle | Registered Nurse | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2016-01-25 |
| 1548696206 | Thomas A. Straub | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2013-09-25 |
| 1861687923 | Daniel Christopher Roth | Physical Medicine & Rehabilitation | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2007-09-12 |
| 1982654828 | Robert Franklin Jackson II | Orthopaedic Surgery | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2006-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| 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 | 46804 |
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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.