NPIMap

Organization Active NPI

Possibilities Northeast, LLC

  • Multi-Specialty Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1063616340
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
POSSIBILITIES NORTHEAST, LLC
Practice address
808 Mill Lake Road
Fort Wayne, IN 46845-6400
Phone
(260) 338-1241
Fax
(260) 338-1231
NPI assigned
Jun 12, 2007
Last updated
Sep 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Nancy MooreNPI 1902946791
Title
Director
Phone
(260) 338-1241

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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

808 Mill Lake Road
Fort Wayne, IN 46845-6400

Mailing address

808 Mill Lake Road
Fort Wayne, IN 46845-6400
Phone (260) 338-1241

National Provider Directory

National Provider Directory
Tax ID family
Possibilities Northeast2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

808 Mill Lake Rd
Fort Wayne, IN 46845

Practitioners & affiliated clinicians

Practitioners 60

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 60

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1063616340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 MILL LAKE ROAD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468456400",
            "telephone_number": "260-338-1241",
            "fax_number": "260-338-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MILL LAKE ROAD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468456400",
            "telephone_number": "260-338-1241",
            "fax_number": "260-338-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSSIBILITIES NORTHEAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "260-338-1241"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 5, 2007; 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.