Individual provider Active NPI

Amy Elizabeth Dunn, LCSW

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1356500151
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005559A Issued in IN
Practice address
10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912
Phone
(260) 387-6340
Fax
(260) 387-6984
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005559A IN Primary

Addresses

Primary practice location

10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912

Mailing address

10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912
Phone (260) 387-6340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000679 IN Practitioner - Clinical Social Worker 7810055324 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34005559AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amy E Dunn LLC Clinical CurrentSince Jun 15, 2020 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Locations

10315 Dawsons Creek Blvd
Ste E
Fort Wayne, IN 46825
Phone (260) 387-3640

Interoperability endpoints

  • Direct secure messaging: amydunn@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1356500151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE E",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-387-6340",
            "fax_number": "260-387-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE E",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-387-6340",
            "fax_number": "260-387-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005559A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.