Fort Wayne Medical Education Program

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORT WAYNE MEDICAL EDUCATION PROGRAM

Doing business as

The Family Medicine Center

Practice address

750 Broadway
Suite 350
Fort Wayne, IN 46802-1412

Phone

(260) 423-2675

Fax

(260) 423-6621

NPI assigned

Aug 11, 2006

Last updated

Apr 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Harris, COO

Title

Chief Operating Officer

Phone

(260) 423-2682

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Family Medicine Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 115

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith J. Derickson, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1538480439
  Medicare reassignment Care Compare group NPD
• Aiwen Liu, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1225561798
  Medicare reassignment Care Compare group NPD
• Kimberly J Schelb, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1114456993
  Medicare reassignment Care Compare group NPD
• Steven Carl Schwieterman, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1154367340
  Medicare reassignment Care Compare group NPD
• Robert Ervin Wilkins, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1992749485
  Medicare reassignment Care Compare group NPD
• Aaron Kimo Coray, DO

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1487853230
  Medicare reassignment Care Compare group
• David T Furman Jr., DO

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1831548510
  Medicare reassignment Care Compare group
• Hector Francisco Perez, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1952385866
  Medicare reassignment NPD
• Sarah J Turner, MD

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1609162676
  Medicare reassignment NPD
• Lisa A Hatcher, M.D.

  • Family Medicine Physician
  • Amery, WI
  • NPI 1932164621

  IN

  Medicare reassignment NPD
• Townsen G Kennington, DPM, AACFAS

  • Foot & Ankle Surgery Podiatrist
  • Williamsport, PA
  • NPI 1558981001

  IN

  Medicare reassignment NPD
• Zachry Lane Waterson, DO

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1902842677
  Medicare reassignment

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1184635153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 150",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021412",
            "telephone_number": "260-423-2682",
            "fax_number": "260-422-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 350",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021412",
            "telephone_number": "260-423-2675",
            "fax_number": "260-423-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE MEDICAL EDUCATION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "260-423-2682",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100050650A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Family Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fort Wayne Fire Department
• Fort Wayne Gi Pathology Services, PC, Inc.
• Fort Wayne Hearing Center & Audiology, Inc. (Quality House Hearing Care Center)
• Fort Wayne Integrative Medicine
• Fort Wayne Medical Clinic PC
• Fort Wayne Medical Education Program Inc
• Fort Wayne Medical Institute
• Fort Wayne Medical Laboratory Corporation
• Fort Wayne Medical Oncology & Hemat (Ft Wayne Med Oncology and Hematology)
• Fort Wayne Medical Oncology and Hematology Inc

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.