Active NPI
Cassandra Moden
- Prosthetics Case Management
- Fort Wayne, IN
National Provider Identifier
1346085156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- Practice address
- 7635 Antebellum Dr
Fort Wayne, IN 46815-6580 - Phone
- (260) 431-1231
- NPI assigned
- Jun 25, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | Primary |
Addresses
Primary practice location
7635 Antebellum Dr
Fort Wayne, IN 46815-6580
Mailing address
7635 Antebellum Dr
Fort Wayne, IN 46815-6580
Phone (260) 431-1231
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1346085156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7635 ANTEBELLUM DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468156580",
"telephone_number": "260-431-1231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7635 ANTEBELLUM DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468156580",
"telephone_number": "260-431-1231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODEN",
"first_name": "CASSANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-25",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": null,
"license": null,
"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 25, 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.