JONATHAN NOTELLE (NPI# 1982061701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982061701 |
| Entity Type | Individual |
| Full Name | JONATHAN NOTELLE |
| Credential | ARNP |
| Practice Address |
1721 Magnavox Way Fort Wayne IN 46804-1537 |
| Mailing Address |
Po Box 670 Huntertown IN 46748-0670 |
| Practice Telephone | 2607483650 |
| Practice Fax Number | 2607483651 |
| Mailing Telephone | 2607483650 |
| Mailing Fax Number | 2607483651 |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2019-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 28202205A | IN | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 71006122A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201350810 | 05 | |
| IN | BCBS | 1003883 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1314 E 7th St Ste 201, Auburn, IN 467062533 | 2607483650 | 2607483651 |
| 2124 N Biomet Dr, Warsaw, IN 465827858 | 2607483650 | 2607483651 |
| 2512 E Dupont Rd Ste 200, Fort Wayne, IN 468251609 | 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 |
| 1548696206 | Thomas A. Straub | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2013-09-25 |
| 1679909931 | Jason T. Gaisford | Physician Assistant | 1721 Magnavox Way, Fort Wayne, IN 46804-1537 | 2013-09-18 |
| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394599 | Laury Farrell | Nurse Practitioner | 6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410 | 2020-10-22 |
| 1730787599 | Crystal Neal | Nurse Practitioner | 4430 Keeneland Ln Unit 202, Fort Wayne, IN 46845-1985 | 2020-10-14 |
| 1225668312 | Kathleen Vanderreyden | Nurse Practitioner | 3005 E State Blvd, Fort Wayne, IN 46805-4736 | 2020-01-17 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1275980690 | April Anderson | Nurse Practitioner | 6920 Pointe Inverness Way Ste 120, Fort Wayne, IN 46804-7926 | 2016-05-16 |
| 1922470970 | Jennifer Carol Littke | Nurse Practitioner | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 | 2015-10-28 |
| 1275956054 | Andrea N Lahrman | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 106, Fort Wayne, IN 46845-1707 | 2014-01-29 |
| 1417213729 | Laura Beth Baker | Nurse Practitioner | 5750 Falls Drive, Fort Wayne, IN 46804-7147 | 2012-04-11 |
| 1447572441 | Kathryn L Smith | Nurse Practitioner | 11104 Parkview Circle Dr Ste 20, Fort Wayne, IN 46845-1733 | 2010-02-18 |
| 1316180144 | Braden M Butterfield Mckinley | Nurse Practitioner | 2101 E Coliseum Blvd Rm 234, Fort Wayne, IN 46805-1445 | 2009-04-09 |
| 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.