Jennifer Ennis, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05005289A Issued in IN

Practice address

11143 Parkview Plaza Dr Ste 100
Fort Wayne, IN 46845-1728

Phone

(260) 266-7400

Fax

(260) 266-7439

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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.

• Mallers & Swoverland Orthopaedic Physical Therapy

  • Physical Therapist
  • Fort Wayne, IN
  • NPI 1700869732
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 28, 2020.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1487728671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11143 PARKVIEW PLAZA DR STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451728",
            "telephone_number": "260-266-7400",
            "fax_number": "260-266-7439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9602 Coldwater Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468252095",
            "country_code": "US",
            "telephone_number": "260-489-9887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9602 Coldwater Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468252095",
            "country_code": "US",
            "telephone_number": "260-489-9887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "JENNIFER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05005289A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Scott England, PT, DPT, CSCS
• Lillian English-Fenton
• Martin Engman, M.D.
• Matthew Engman
• Anna Kayleen Ennis, LCSW
• Breanna Eno, RD
• Deniya Ensley
• ENT Realty Corp
• Envision Eye Care LLC
• Mitchell McKay Enyart

• All providers in Fort Wayne, IN
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.