Individual provider Active NPI

Maegan Rochelle Hayes

  • Social Worker
  • Fort Wayne, IN
National Provider Identifier
1306549878
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
99126014A Issued in IN
Practice address
6208 Constitution Dr Ste A1
Fort Wayne, IN 46804-1585
Phone
(260) 699-7275
Fax
(260) 233-6572
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 99126014A IN Primary

Addresses

Primary practice location

6208 Constitution Dr Ste A1
Fort Wayne, IN 46804-1585

Mailing address

6208 Constitution Dr Ste A1
Fort Wayne, IN 46804-1585
Phone (260) 699-7275

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99126014AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Intention Services, LLC CurrentSince Oct 20, 2024 Accepting new patients

Locations

6208 Constitution Dr
Ste A1
Fort Wayne, IN 46804
Phone (260) 699-7275

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.

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1306549878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6208 CONSTITUTION DR STE A1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041585",
            "telephone_number": "260-699-7275",
            "fax_number": "260-233-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6208 CONSTITUTION DR STE A1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041585",
            "telephone_number": "260-699-7275",
            "fax_number": "260-233-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "MAEGAN",
        "middle_name": "ROCHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "IN",
            "license": "99126014A",
            "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 Sep 4, 2024; 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.