Individual provider Active NPI

Anne Therese Venderley, DC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1114438595
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003002A Issued in IN
Practice address
6388 W Jefferson Blvd Ste B
Fort Wayne, IN 46804-3075
Phone
(260) 432-9355
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003002A IN Primary

Addresses

Primary practice location

6388 W Jefferson Blvd Ste B
Fort Wayne, IN 46804-3075

Mailing address

8315 Redstone Dr
Fort Wayne, IN 46835-4258
Phone (260) 609-8315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1114438595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 REDSTONE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468354258",
            "telephone_number": "260-609-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6388 W JEFFERSON BLVD STE B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468043075",
            "telephone_number": "260-432-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDERLEY",
        "first_name": "ANNE",
        "middle_name": "THERESE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003002A",
            "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 Oct 12, 2017; 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.