SHAWN P. LAZOFF (NPI# 1982993309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982993309 |
| Entity Type | Individual |
| Full Name | SHAWN P. LAZOFF |
| Credential | DO |
| Practice Address |
3534 Brooklyn Ave Fort Wayne IN 46809-1361 |
| Mailing Address |
6920 Pointe Inverness Way Ste 200 Fort Wayne IN 46804-7934 |
| Practice Telephone | 2604785170 |
| Practice Fax Number | 2604785145 |
| Mailing Telephone | 2604793516 |
| Mailing Fax Number | 2604793520 |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 02004719A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201337850 | 05 |
| Street Address |
3534 BROOKLYN AVE |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46809-1361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659362200 | Herbert K.j. Acker | Family Medicine | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2005-11-02 |
| 1659917771 | Lyndi Davis | Nurse Practitioner | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2019-11-24 |
| 1033752001 | Marion Melcher | Physical Therapist | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2019-10-23 |
| 1689104242 | Andrew Wieging | Family Medicine | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2017-06-15 |
| 1871049981 | Mark Sexton | Physical Therapist | 3534 Brooklyn Ave, Fort Wayne, IN 46809 | 2016-08-29 |
| 1710275664 | Lutheran Medical Group LLC | Durable Medical Equipment & Medical Supplies | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2011-07-13 |
| 1992090971 | Christopher A. Baltes | Family Medicine | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2011-06-17 |
| 1578876785 | David S. Mohan | Family Medicine | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2010-07-16 |
| 1902068828 | Tara Marie Meyer | Physical Therapist | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2008-07-01 |
| 1356532667 | Crystal M Bourcier | Physical Therapist | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 | 2007-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497038574 | Zachary L Roberts | Pharmacist | 12279 Bluffton Road, Fort Wayne, IN 46809 | 2011-09-24 |
| 1679660278 | Kool Smiles In Ft. Wayne, PC | Dentist | 1852 Bluffton Road, Ft. Wayne, IN 46809 | 2006-10-06 |
| 1477512564 | Brian Thomas Raypole | Specialist/Technologist | 5050 N. Clinton Street, Fort Wayne, IN 46809 | 2006-03-20 |
| 1669016895 | Trinity Health Pharmacy Services, LLC | Pharmacy | 12279 Bluffton Road, Fort Wayne, IN 46809 | 2019-10-31 |
| 1841573318 | Vicki Eileen Caccamo | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809 | 2011-09-21 |
| 1265588404 | May R. Dahman | Specialist | 1733 Kinsmoor Ave, Fort Wayne, IN 46809-1025 | 2007-01-27 |
| 1134746209 | Laurel Schroeder | Occupational Therapist | 1726 Bluffton Rd, Fort Wayne, IN 46809-1305 | 2020-07-06 |
| 1730793605 | Cody Craig | Physical Therapist | 1726 Bluffton Rd, Fort Wayne, IN 46809-1305 | 2020-09-08 |
| 1952497166 | Ajay Joshi | Dentist | 1852 Bluffton Rd, Fort Wayne, IN 46809-1306 | 2006-10-05 |
| 1255855011 | Sahar Hameed | Dentist | 1852 Bluffton Rd, Fort Wayne, IN 46809-1306 | 2017-08-02 |
| Find all providers in zip 46809 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760912026 | Christina A Tatara | Family Medicine | 6511 E State Blvd, Fort Wayne, IN 46815-7026 | 2017-06-19 |
| 1700317633 | Robert Campbell | Family Medicine | 7411 Hope Dr, Fort Wayne, IN 46815-5687 | 2017-03-22 |
| 1487196424 | American Vein Institute LLC | Family Medicine | 10020 Dupont Circle Ct Ste 140, Fort Wayne, IN 46825-1621 | 2016-11-08 |
| 1831547124 | Anna Menze | Family Medicine | 10307 Dupont Circle Dr W Ste A, Fort Wayne, IN 46825-1633 | 2016-05-27 |
| 1407203672 | Credo Health Group, LLC | Family Medicine | 10228 Dupont Circle Dr E # 100b, Fort Wayne, IN 46825-1611 | 2016-05-18 |
| 1649625104 | Gabrielle Paloma Acquaro | Family Medicine | 7806 W Jefferson Blvd Ste E, Fort Wayne, IN 46804-4180 | 2016-05-03 |
| 1720491731 | John E Marx | Family Medicine | 1007 W Rudisill Blvd, Fort Wayne, IN 46807-2170 | 2014-06-06 |
| 1457763252 | Amy Simpson | Family Medicine | 1818 Carew St Ste 120, Fort Wayne, IN 46805-4764 | 2014-05-28 |
| 1932536083 | Clifford James Shultz | Family Medicine | 2616 Covington Pointe Trl, Fort Wayne, IN 46804-2773 | 2013-10-03 |
| 1164860086 | Andrew J Mullally | Family Medicine | 10050 Auburn Park Dr, Fort Wayne, IN 46825-2389 | 2013-06-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46809 |
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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.