Edwin Requillo Capuyan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05004058A Issued in IN

Practice address

5523 Stonehill CT
Fort Wayne, IN 46835-4199

Phone

(260) 579-8634

NPI assigned

Sep 21, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Children'S Milestone Inc

  • Physical Therapist
  • Fort Wayne, IN
  • NPI 1568513166
  NPD (past)

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221955200000",
    "number": "1508016049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5523 STONEHILL CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468354199",
            "telephone_number": "260-579-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5523 STONEHILL CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468354199",
            "telephone_number": "260-579-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUYAN",
        "first_name": "EDWIN",
        "middle_name": "REQUILLO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-21",
        "last_updated": "2008-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05004058A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine R Capen, RD LD
• Capital Senior Living Properties 4, Inc.
• Rachel Capito, PHARMD
• Caylie Cappelli, NP
• Cheryl Bandolon Capuyan
• Caraconnect Counseling LLC
• Kathryn Carboneau, M.D.
• Dustin J Carboni, COTA
• Goldy Beatriz Carbunaru, MD
• Stephanie Marie Carcione, PHARMD

• Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2008; 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.