Organization Active NPI

T-Med Services, Inc

  • Neurology Physician
  • Fort Wayne, IN
National Provider Identifier
1396080156
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01070620A Issued in IN
Legal business name
T-MED SERVICES, INC
Practice address
2510 E Dupont Rd
Suite 201
Fort Wayne, IN 46825-1601
Phone
(260) 267-6383
Fax
(888) 342-1601
NPI assigned
Dec 5, 2012
Last updated
Oct 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Dr. John Orvil Collins, MDNPI 1003830399
Title
President
Phone
(260) 267-6142

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71002635A IN
Counseling Psychologist 103TC1900X 20042429A IN
Neurology Physician 2084N0400X 01070620A IN Primary

Addresses

Primary practice location

2510 E Dupont Rd
Suite 201
Fort Wayne, IN 46825-1601

Mailing address

6435 W Jefferson Blvd
#241
Fort Wayne, IN 46804-6203
Phone (260) 267-6142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131009001712 IN Part B Supplier - Clinic/Group Practice 7012141864 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

1716 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 490-5111

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1396080156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 W JEFFERSON BLVD",
            "address_2": "#241",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046203",
            "telephone_number": "260-267-6142",
            "fax_number": "260-918-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E DUPONT RD",
            "address_2": "SUITE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251601",
            "telephone_number": "260-267-6383",
            "fax_number": "888-342-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T-MED SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ORVIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-267-6142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002635A",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20042429A",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01070620A",
            "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 Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.