Fawver Waldo Clinic LLP

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

FAWVER WALDO CLINIC LLP

Practice address

6920 Pointe Inverness Way
Suite 250
Fort Wayne, IN 46804-7926

Phone

(260) 436-4060

Fax

(260) 436-5713

NPI assigned

Aug 15, 2006

Organization subpart

No

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

Authorized official

Name

Jay D Fawver, MDNPI 1164457404

Title

Managing Partner

Phone

(260) 436-4060

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jay Fawver, MD

  • Psychiatry Physician
  • Angola, IN
  • NPI 1164457404
  NPD (past) Authorized official

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1174536346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY",
            "address_2": "SUITE 250",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047926",
            "telephone_number": "260-436-4060",
            "fax_number": "260-436-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY",
            "address_2": "SUITE 250",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047926",
            "telephone_number": "260-436-4060",
            "fax_number": "260-436-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAWVER WALDO CLINIC LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FAWVER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "260-436-4060",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DD0871",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Faux, RN
• Kelly N Fawcett, NP
• Eniola Oluwatosin Fawibe, NP-C
• Omotayo Temitope Fawibe, MD
• Jacob M Fawley
• David Arnold Feaker Jr., DO
• Leah M Fear, LMHCA
• Melissa K Fearnow, RDN, LD
• Ruth Fearnow
• Allyson Nicole Feasel, DDS

• Adolescent and Children Mental Health Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Adolescent and Children Mental Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.