Active NPI
Brian Keith Tomlinson, PA
- Physician Assistant
- Fort Wayne, IN
National Provider Identifier
1265453989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10000148
- Practice address
- 2200 Randallia Dr
Fort Wayne, IN 46805-4638 - Phone
- (260) 373-4000
- Fax
- (260) 482-4442
- NPI assigned
- Jul 21, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10000148 | IN | Primary |
Addresses
Primary practice location
2200 Randallia Dr
Fort Wayne, IN 46805-4638
Mailing address
3640 New Vision Drive
Suite a
Fort Wayne, IN 46845-1717
Phone (260) 482-4440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10000148 | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Health System, LLC | Past | Accepting new patients | |
| Emergency Medicine of Indiana | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Fort Wayne, IN
- NPI 1952356883
-
- Medicare Defined Swing Bed Hospital Unit
- Fort Wayne, IN
- NPI 1538812946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373241600000",
"number": "1265453989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3640 NEW VISION DRIVE",
"address_2": "SUITE A",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451717",
"telephone_number": "260-482-4440",
"fax_number": "260-482-4442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 RANDALLIA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468054638",
"telephone_number": "260-373-4000",
"fax_number": "260-482-4442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMLINSON",
"first_name": "BRIAN",
"middle_name": "KEITH",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2013-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10000148",
"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, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.