NPIMap

Organization Active NPI

Indiana University Health Fort Wayne Physicians, LLC

  • Family Medicine Physician
  • Muncie, IN
National Provider Identifier
1316550445
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INDIANA UNIVERSITY HEALTH FORT WAYNE PHYSICIANS, LLC
Practice address
2401 W University Ave
Muncie, IN 47303-3428
Phone
(765) 747-3111
NPI assigned
Aug 28, 2020
Last updated
Nov 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Authorized official

Name
Jonathan W. Vanator
Title
Cfo
Phone
(317) 963-3395

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2401 W University Ave
Muncie, IN 47303-3428

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959
Phone (888) 484-3258

Other practice location 1

7230 Engle Rd Ste 100
Fort Wayne, IN 46804-2234
Phone (260) 234-5400

Other practice location 2

7411 Hope Dr Ste B
Fort Wayne, IN 46815-5687
Phone (260) 234-5400

Other practice location 3

7411 Hope Dr Ste C
Fort Wayne, IN 46815-5687
Phone (260) 234-5400

Other practice location 4

10215 Auburn Park Dr
Fort Wayne, IN 46825-2387
Phone (260) 234-5400

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

256 E Pettit Ave
Ste 100
Fort Wayne, IN 46806

9821 Lima Rd
Fort Wayne, IN 46818
Phone (260) 240-5027

10101 Ernst Rd
Ste 1100
Roanoke, IN 46783

10101 Ernst Rd
Ste 1200
Roanoke, IN 46783

10101 Ernst Rd
Ste 1500
Roanoke, IN 46783

Practitioners & affiliated clinicians

Practitioners 72

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 72

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1316550445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "888-484-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033428",
            "telephone_number": "765-747-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7230 Engle Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468042234",
            "country_code": "US",
            "telephone_number": "260-234-5400",
            "fax_number": "260-234-5410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7411 Hope Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468155687",
            "country_code": "US",
            "telephone_number": "260-234-5400",
            "fax_number": "260-234-5696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7411 Hope Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468155687",
            "country_code": "US",
            "telephone_number": "260-234-5400",
            "fax_number": "260-234-5395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10215 Auburn Park Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468252387",
            "country_code": "US",
            "telephone_number": "260-234-5400",
            "fax_number": "260-234-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH FORT WAYNE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "VANATOR",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-963-3395"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.