NPIMap

Organization Active NPI

Associated Family Medical Consultants PC

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1265454755
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASSOCIATED FAMILY MEDICAL CONSULTANTS PC
Practice address
6400 Rothman Rd
Fort Wayne, IN 46835-1366
Phone
(260) 485-1544
Fax
(260) 485-0490
NPI assigned
Jul 24, 2006
Last updated
Jun 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Authorized official

Name
Brent W Coil, MDNPI 1063458255
Title
President
Phone
(260) 486-6197

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

6400 Rothman Rd
Fort Wayne, IN 46835-1366

Mailing address

6400 Rothman Rd
Fort Wayne, IN 46835-1366
Phone (260) 485-1544

Other identifiers 1

IdentifierTypeStateIssuer
100462980MedicaidIN

National Provider Directory

National Provider Directory

Locations

2510 E DuPont Rd
#21
Fort Wayne, IN 46825
Phone (260) 489-8255

6400 Rothman Rd
Fort Wayne, IN 46835
Phone (219) 489-8563

7938 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-8748

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1265454755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 ROTHMAN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351366",
            "telephone_number": "260-485-1544",
            "fax_number": "260-485-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 ROTHMAN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351366",
            "telephone_number": "260-485-1544",
            "fax_number": "260-485-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED FAMILY MEDICAL CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "COIL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-486-6197",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100462980",
            "state": "IN"
        }
    ],
    "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 Jun 4, 2009; 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.