Fresh Start Recovery Group LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

FRESH START RECOVERY GROUP LLC

Practice address

3464 Stellhorn Rd
Fort Wayne, IN 46815-4630

Phone

(260) 402-9145

NPI assigned

Jan 25, 2023

Organization subpart

No

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

Authorized official

Name

Eamon Christopher Poor

Title

Office Manager

Phone

(260) 402-1503

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1023724861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11788 WHISTLING TRL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468180144",
            "telephone_number": "260-402-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154630",
            "telephone_number": "260-402-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START RECOVERY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "POOR",
        "authorized_official_first_name": "EAMON",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "260-402-1503"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Nichole Freese, MD
• Madeline Freiburger
• Joya Frelin
• James E French, O.D.
• Karen Lee Frerking, OTR/L
• Jill Freshour, LCSW
• Marissa K Freson, MSED, LMFTA
• Frey Vision Group of Indiana Inc
• Aaron Christopher Frey, O.D.
• Emery Frey, PHARMD

• Addiction Medicine (Family Medicine) Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Addiction Medicine (Family Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.