Individual provider Active NPI

John T Oo, NP

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1396265864
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007147A Issued in IN
Practice address
1330 N Coliseum Blvd
Fort Wayne, IN 46805-5526
Phone
(260) 447-8982
NPI assigned
Jun 26, 2017
Last updated
Jun 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71007147A IN Primary

Addresses

Primary practice location

1330 N Coliseum Blvd
Fort Wayne, IN 46805-5526

Mailing address

3212 Rockwood Dr
Fort Wayne, IN 46815-6137

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829000800 IN Practitioner - Nurse Practitioner 5092088922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anthony Medical Associates P CGroup PAC ID 8123932472, 3 clinicians

Practice addresses (Care Compare)

1330 N Coliseum Blvd
Fort Wayne, IN 46805-5526
Phone (260) 447-8982

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71007147AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Medical Associates P C CurrentSince Aug 1, 2017 Accepting new patients

Locations

1330 N Coliseum Blvd
Fort Wayne, IN 46805
Phone (260) 447-8982

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1396265864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 ROCKWOOD DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055526",
            "telephone_number": "260-447-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OO",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007147A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.