Active NPI
Robert Harrison
- Physical Therapist
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05013338A
- Practice address
- 11143 Parkview Plaza Dr Ste 100
Fort Wayne, IN 46845-1728 - Phone
- (260) 266-7400
- NPI assigned
- Jun 18, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05013338A | IN | Primary |
Addresses
Primary practice location
11143 Parkview Plaza Dr Ste 100
Fort Wayne, IN 46845-1728
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other practice location 1
12844 Coldwater Rd Ste D
Fort Wayne, IN 46845-8833
Phone (260) 497-7191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190826001089 | IN | Practitioner - Physical Therapist in Private Practice | 0143558379 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Parkview Health System Inc
Practice addresses (Care Compare)
11143 Parkview Plaza Dr
Suite 100
Fort Wayne, IN 46845-1728
Phone (260) 266-7400
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.53 of 100
- Quality
- 70
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05013338A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Current | 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
11143 Parkview Plaza Dr
Ste 100
Fort Wayne, IN 46845
Phone (260) 266-7400
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Fort Wayne, IN
- NPI 1447585153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1194385575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11143 PARKVIEW PLAZA DR STE 100",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451728",
"telephone_number": "260-266-7400"
}
],
"practiceLocations": [
{
"address_1": "12844 Coldwater Rd Ste D",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468458833",
"country_code": "US",
"telephone_number": "260-497-7191",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRISON",
"first_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-18",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05013338A",
"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 May 11, 2021; 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.