Individual provider Active NPI

Jason Hoeppner, P.T.

  • Physical Therapist
  • Fort Wayne, IN
National Provider Identifier
1164449773
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05004098A Issued in IN
Practice address
5050 N Clinton St
Fort Wayne, IN 46825-5822
Phone
(260) 471-6202
Fax
(260) 471-4272
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05004098A IN Primary

Addresses

Primary practice location

5050 N Clinton St
Fort Wayne, IN 46825-5822

Mailing address

10809 River Oaks Dr
Fort Wayne, IN 46845-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080307000090 IN Practitioner - Physical Therapist in Private Practice 2466537014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05004098AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc CurrentSince May 21, 2025 Accepting new patients
Redimed Dekalb LLC Physical Therapist Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164449773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10809 RIVER OAKS DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822",
            "telephone_number": "260-471-6202",
            "fax_number": "260-471-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOEPPNER",
        "first_name": "JASON",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05004098A",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.