Active NPI
Ace Medical Supply, Inc
- Durable Medical Equipment & Medical Supplies
- Fort Wayne, IN
National Provider Identifier
1073589081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- ACE MEDICAL SUPPLY, INC
- Practice address
- 6155 Stoney Creek Dr
Fort Wayne, IN 46825-4409 - Phone
- (260) 483-3516
- Fax
- (260) 471-2797
- NPI assigned
- Feb 28, 2006
- Last updated
- Feb 3, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Janelle D Ford
- Title
- Owner
- Phone
- (260) 483-3516
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | Primary | |
| Prosthetic/Orthotic Supplier | 335E00000X | NU |
Addresses
Primary practice location
6155 Stoney Creek Dr
Fort Wayne, IN 46825-4409
Mailing address
6155 Stoney Creek Dr
Fort Wayne, IN 46825-4409
Phone (260) 483-3516
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000212825 | Other | IN | BLUE CROSS BLUE SHIELD |
| 200310680A | Medicaid | IN | |
| 2626512 | Other | KY | KENTUCKY PASSPORT |
| 219865074A | Medicaid | GA | |
| 6201052000 | Medicaid | WV | |
| 874370556 | Medicaid | MI | |
| 026687600 | Medicaid | MN | |
| 756968 | Medicaid | AZ | |
| 90004821 | Medicaid | KY | |
| 2337813 | Medicaid | OH | |
| 2441973000 | Other | KY | PASSPORT ADVANTAGE |
| 626219000 | Medicaid | MO | |
| 200255500A | Medicaid | KS | |
| 82638200 | Medicaid | WI |
Other names 1
- Ace Forms & Systems
National Provider Directory
National Provider DirectoryLocations
6155 Stoney Creek Dr
Fort Wayne, IN 46825
Phone (260) 483-3516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1328227200000",
"number": "1073589081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6155 STONEY CREEK DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468254409",
"telephone_number": "260-483-3516",
"fax_number": "260-471-2797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6155 STONEY CREEK DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468254409",
"telephone_number": "260-483-3516",
"fax_number": "260-471-2797"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACE MEDICAL SUPPLY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-28",
"last_updated": "2012-02-03",
"status": "A",
"authorized_official_last_name": "FORD",
"authorized_official_first_name": "JANELLE",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "260-483-3516",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000212825",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200310680A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KENTUCKY PASSPORT",
"identifier": "2626512",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "219865074A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6201052000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "874370556",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "026687600",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "756968",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "90004821",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2337813",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT ADVANTAGE",
"identifier": "2441973000",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "626219000",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200255500A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "82638200",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Ace Forms & Systems",
"code": "4",
"type": "Former Legal Business Name"
}
]
}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 Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.