People of Conviction

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PEOPLE OF CONVICTION

Practice address

1325 S Anthony Blvd
Fort Wayne, IN 46803-2107

Phone

(260) 424-3420

Fax

(260) 424-3420

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Saharra L Bledsoe

Title

Exe Director

Phone

(260) 424-3420

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346372653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468032107",
            "telephone_number": "260-424-3420",
            "fax_number": "260-424-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468032107",
            "telephone_number": "260-424-3420",
            "fax_number": "260-424-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOPLE OF CONVICTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLEDSOE",
        "authorized_official_first_name": "SAHARRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXE DIRECTOR",
        "authorized_official_telephone_number": "260-424-3420",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew M Pennucci, DPT
• Phillip Craig Penny I, D.O.
• Christina Anita Pentsos, RN
• Beulah T. Penumudi, M.D.
• People and Pathways Consulting LLC
• Evan Pepple, RBT
• Shana Marie Pepple, MA, BCBA
• Stephan Edwin Pepple, M.D.
• Stephen Alan Pepple
• Walter David Pepple, MD

• Exclusive Provider Organization in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Exclusive Provider Organization in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.