Kendallville Family Care Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01036102 Issued in IN

Legal business name

KENDALLVILLE FAMILY CARE CENTER INC

Practice address

130 Lake Terrace Dr
Kendallville, IN 46755-1819

Phone

(260) 349-9240

Fax

(260) 349-9244

NPI assigned

Apr 1, 2010

Organization subpart

No

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

Authorized official

Name

Rex A Flenar, M.D.NPI 1710962170

Title

Owner

Phone

(260) 349-9240

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Rex A. Flenar, M.D.

  • Family Medicine Physician
  • Kendallville, IN
  • NPI 1710962170
  Authorized official Same address or phone

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1396060307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LAKE TERRACE DR",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551819",
            "telephone_number": "260-349-9240",
            "fax_number": "260-349-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LAKE TERRACE DR",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551819",
            "telephone_number": "260-349-9240",
            "fax_number": "260-349-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALLVILLE FAMILY CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-01",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "FLENAR",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-349-9240",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01036102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201009760A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jones Family Dental, LLC (Jones Family Dental)
• Bridget Joseph
• Susan K Kamara, LMHC
• Rebecca M Kellett, BCBA
• Kendallville Chiropractic Center Inc
• Kendallville Family Dentistry LLC
• Sarah M Kintz
• Lance Edward Kjendalen, D.C.
• Sarah Kay Kline, MSED, LMHC
• Stanislawa Krystyna Koczorowska, MD

• Family Medicine Physician in Kendallville, IN
• Providers in Kendallville, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.