Active NPI
Sara L Speith, NP
- Nurse Practitioner
- Fort Wayne, IN
National Provider Identifier
1275770802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71003850A
- Practice address
- 2512 E Dupont Rd
Suite 200
Fort Wayne, IN 46825-1609 - Phone
- (260) 432-4400
- Fax
- (260) 696-6898
- NPI assigned
- Jan 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28176966A | IN | |
| Nurse Practitioner | 363L00000X | 71003850A | IN | Primary |
Addresses
Primary practice location
2512 E Dupont Rd
Suite 200
Fort Wayne, IN 46825-1609
Mailing address
2512 E Dupont Rd
Suite 200
Fort Wayne, IN 46825-1609
Phone (260) 432-4400
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28176966A | IN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Trauma Surgery Physician
- Fort Wayne, IN
- NPI 1669576997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1275770802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2512 E DUPONT RD",
"address_2": "SUITE 200",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251609",
"telephone_number": "260-432-4400",
"fax_number": "260-696-6898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2512 E DUPONT RD",
"address_2": "SUITE 200",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251609",
"telephone_number": "260-432-4400",
"fax_number": "260-696-6898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEITH",
"first_name": "SARA",
"middle_name": "L",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-20",
"last_updated": "2012-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28176966A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71003850A",
"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 Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.