Damon E Greven, NP-C
Individual provider Active NPI Nurse Practitioner · Garrett, IN
NPI 1245428366 · NPPES record last updated Jan 5, 2022
Key facts
- NPI
- 1245428366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71002515A (IN)
- Practice address
- 672 County Road 64
Garrett, IN 46738-9754 - Phone
- (260) 466-7349
- NPI assigned
- Oct 15, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- RP Care LLC
Practice addresses (Care Compare)
6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275
Hospital & facility affiliations
- Parkview Dekalb Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071219000763 | IN | Practitioner - Nurse Practitioner | 6507956109 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71002515A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RP Care LLC | Current |
Accepting new patients | |
| Parkview Health System, Inc. | Nurse Practitioner | Current |
Accepting new patients |
| Parkview Health System Inc | Nurse Practitioner | Current | Accepting new patients |
Locations
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020
6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275
3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210
2512 E DuPont Rd
Ste 100
Fort Wayne, IN 46825
Phone (260) 347-4459
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71002515A | IN | Yes |
Addresses
Primary practice location
672 County Road 64
Garrett, IN 46738-9754
Mailing address
672 County Road 64
Garrett, IN 46738-9754
Phone (260) 466-7349
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0748972 | Medicaid | OH | |
| 000000566036 | Other | IN | ANTHEM |
| 200879230 | Medicaid | IN | |
| 100081380 | Medicaid | IN | |
| 2788354 | Medicaid | OH | |
| P00664349 | Other | IN | MEDICARE RAILROAD |
Other providers in Garrett, IN
- Dekalb Memorial Pharmacare LLC
- Element Care Group
- Garrett Family Dentistry LLC
- Garrett Pharmacare, LLC
- Garrett-Keyser-Butler Community School District
- Vicki L Haines
- Carmynn Louise Hatch
- Nancy Hoot
- Gretchen Heidi Jenkins
- Johnson Memorial Hospital
All providers in Garrett, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.