LINCOLN PEDIC CLINIC, INC. (NPI# 1760486393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760486393 |
| Entity Type | Organization |
| Organization Name | LINCOLN PEDIC CLINIC, INC. |
| Practice Address |
12311 Autumn Breeze Dr Fort Wayne IN 46845-9111 |
| Practice Telephone | 2606378414 |
| Practice Fax Number | 2606378152 |
| Mailing Telephone | 2606378414 |
| Mailing Fax Number | 2606378152 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2010-11-30 |
| Authorized Official Name | MS. JANET ALYCE PAUNWAR (PRESIDENT) |
| Authorized Official Telephone | 2606378414 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 07000776A | IN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100210380A | 05 | |
| IN | ANTHEM BLUE CROSS | 000000235683 | 01 |
| IN | PALMETTO GBA | C31367 | 01 |
| Street Address |
12311 AUTUMN BREEZE DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-9111 |
| 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 | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417337353 | Hazim Ibrahim | Podiatrist | 7527 Thoroughbred Dr Apt 3d, Fort Wayne, IN 46804 | 2015-06-05 |
| 1760683593 | Toes R Us, Inc. | Podiatrist | 6200 Bluffton Rd, Fort Wayne, IN 46809-2260 | 2007-05-30 |
| 1871605147 | Dennis John Chubinski | Podiatrist | 8028 Carnegie Blvd., 400, Fort Wayne, IN 46804-5788 | 2006-08-31 |
| 1114956844 | David K Wysong | Podiatrist | 3012 E State Blvd, Fort Wayne, IN 46805-4737 | 2006-07-03 |
| 1235182643 | Richard M. Hilker, Dpm, P.C. | Podiatrist | 10323 Dawsons Creek Blvd, Bldg. 10-c, Fort Wayne, IN 46825-1910 | 2006-05-18 |
| 1134104474 | Lynn H Stafford | Podiatrist | 7559 W Jefferson Blvd, Fort Wayne, IN 46804-4131 | 2005-12-09 |
| 1487637377 | Richard M Hilker | Podiatrist | 10323 Dawsons Creek, Bldg 10 C, Fort Wayne, IN 46825-1910 | 2005-11-23 |
| 1508867177 | Gary Michael Torkeo | Podiatrist | 4011 W Jefferson Blvd, Suite 175, Fort Wayne, IN 46804-6853 | 2005-08-09 |
| 1346247061 | Michael Steven Worpell | Podiatrist | 1234 E Dupont Rd, 2 1, Fort Wayne, IN 46825-1545 | 2005-07-07 |
| 1124021100 | Karen F Sloane | Podiatrist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2005-05-24 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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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.