NPIMap

Nicholas Allen, OT

Individual provider Active NPI Occupational Therapist · Fort Wayne, IN

NPI 1124877980 · NPPES record last updated May 17, 2024

Key facts

NPI
1124877980
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
Practice address
12722 Tonkel Rd Ste 102
Fort Wayne, IN 46845-8201
Phone
(260) 739-0300
NPI assigned
May 15, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Protailored Physical Therapy LLC Current
since Jul 10, 2024		 Accepting new patients

Locations

3730 Maplecrest Rd
Fort Wayne, IN 46815
Phone (260) 739-0300

1520 N Hill Dr
Fort Wayne, IN 46825
Phone (260) 739-0300

4011 W Jefferson Blvd
Ste 175
Fort Wayne, IN 46804
Phone (260) 436-4438

14413 Illinois Rd
Ste D
Fort Wayne, IN 46814
Phone (260) 739-0300

12722 Tonkel Rd
Ste 102
Fort Wayne, IN 46845
Phone (260) 739-0300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Yes

Addresses

Primary practice location

12722 Tonkel Rd Ste 102
Fort Wayne, IN 46845-8201

Mailing address

12722 Tonkel Rd Ste 102
Fort Wayne, IN 46845-8201
Phone (260) 739-0300

Other providers in Fort Wayne, IN

All providers in Fort Wayne, IN · Occupational Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.