NPIMap

Organization Active NPI

Wabash Em I Medical Services PC

  • Physician Assistant
  • Logansport, IN
National Provider Identifier
1013110295
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
WABASH EM I MEDICAL SERVICES PC
Practice address
1101 Michigan Ave
Logansport, IN 46947-1528
Phone
(574) 753-7541
Fax
(574) 753-1507
NPI assigned
Jun 6, 2007
Last updated
Aug 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathy Kondas
Title
Officer
Phone
(954) 838-2371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IN Primary
Nurse Practitioner 363L00000X IN

Addresses

Primary practice location

1101 Michigan Ave
Logansport, IN 46947-1528

Mailing address

533 W North Ave
Ste. 102
Elmhurst, IL 60126-2135
Phone (800) 732-1066

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1013110295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W NORTH AVE",
            "address_2": "STE. 102",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262135",
            "telephone_number": "800-732-1066",
            "fax_number": "630-941-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471528",
            "telephone_number": "574-753-7541",
            "fax_number": "574-753-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WABASH EM I MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.