Organization Active NPI

Fitch Chiropractic LLC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1043539448
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08000206A Issued in IN
Legal business name
FITCH CHIROPRACTIC LLC
Practice address
3010 E. State Blvd
Suite 500
Fort Wayne, IN 46805-4700
Phone
(260) 471-7493
Fax
(260) 471-6935
NPI assigned
May 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Authorized official

Name
Dr. Victor K Fitch, D.C.
Title
Owner
Phone
(260) 471-7493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08000206A IN Primary

Addresses

Primary practice location

3010 E. State Blvd
Suite 500
Fort Wayne, IN 46805-4700

Mailing address

3010 E. State Blvd
Suite 500
Fort Wayne, IN 46805-4700
Phone (260) 471-7493

Other identifiers 2

IdentifierTypeStateIssuer
100049760MedicaidIN
350664222OtherINMEDICARE RR

National Provider Directory

National Provider Directory

Locations

6421 Georgetown North Blvd
Fort Wayne, IN 46815
Phone (260) 471-7493

3010 E State Blvd
Ste 500
Fort Wayne, IN 46805
Phone (260) 471-7493

NPI Registry JSON

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1043539448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 E. STATE BLVD",
            "address_2": "SUITE 500",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054700",
            "telephone_number": "260-471-7493",
            "fax_number": "260-471-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 E. STATE BLVD",
            "address_2": "SUITE 500",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054700",
            "telephone_number": "260-471-7493",
            "fax_number": "260-471-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITCH CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "FITCH",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-471-7493",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000206A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100049760",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "350664222",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.