NPIMap

Organization Active NPI

Fort Wayne Allergy and Asthma Consultants, Inc.

  • Specialist
  • Fort Wayne, IN
National Provider Identifier
1487734109
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FORT WAYNE ALLERGY AND ASTHMA CONSULTANTS, INC.
Practice address
7964 W. Jefferson Blvd.
Fort Wayne, IN 46804-4140
Phone
(260) 436-5670
Fax
(260) 436-4706
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Heather McClellan
Title
Office Manager
Phone
(260) 436-5670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

7964 W. Jefferson Blvd.
Fort Wayne, IN 46804-4140

Mailing address

7964 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 436-5670

Other identifiers 1

IdentifierTypeStateIssuer
200291770AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060228000408 IN Part B Supplier - Clinic/Group Practice 8921014978 Receives reassigned benefits from 6 practitioners
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory
Tax ID family
Fort Wayne Allergy and Asthma Consultants Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1314 E 7th St
Ste 201
Auburn, IN 46706
Phone (260) 927-0400

2810 DuPont Commerce Ct
Fort Wayne, IN 46825
Phone (260) 436-5670

441 N Wabash Ave
Ste 470
Marion, IN 46952
Phone (260) 436-5670

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1487734109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7964 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-436-5670",
            "fax_number": "260-436-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7964 W. JEFFERSON BLVD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-436-5670",
            "fax_number": "260-436-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE ALLERGY AND ASTHMA CONSULTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "260-436-5670"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200291770A",
            "state": "IN"
        }
    ],
    "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 Apr 20, 2026; 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.