Organization Active NPI

Fort Wayne Pediatrics, PC

  • Pediatrics Physician
  • Fort Wayne, IN
National Provider Identifier
1063595536
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FORT WAYNE PEDIATRICS, PC
Practice address
2810 Dupont Commerce CT
Fort Wayne, IN 46825-2393
Phone
(260) 490-7337
Fax
(260) 489-8937
NPI assigned
Oct 20, 2006
Last updated
Mar 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Dr. Amy L Fuchs, MDNPI 1063462166
Title
President
Phone
(260) 490-7337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

2810 Dupont Commerce CT
Fort Wayne, IN 46825-2393

Mailing address

2810 Dupont Commerce CT
Fort Wayne, IN 46825-2393
Phone (260) 490-7337

Other identifiers 1

IdentifierTypeStateIssuer
100080960MedicaidIN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0678173Fort Wayne Pediatrics Lab2810 Dupont Commerce CT, Fort Wayne, IN 46825Certificate of waiverJan 2, 2027

National Provider Directory

National Provider Directory

Locations

2514 E DuPont Rd
Fort Wayne, IN 46825

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1063595536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 DUPONT COMMERCE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252393",
            "telephone_number": "260-490-7337",
            "fax_number": "260-489-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 DUPONT COMMERCE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252393",
            "telephone_number": "260-490-7337",
            "fax_number": "260-489-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "FUCHS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-490-7337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080960",
            "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 Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.