NPIMap

Organization Active NPI

Indiana University

Doing business as IU Fort Wayne Lafayette Street Family Health Clinic

  • Ambulatory Family Planning Facility
  • Fort Wayne, IN
National Provider Identifier
1508069972
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Family Planning FacilityTaxonomy code 261QA0005X
Legal business name
INDIANA UNIVERSITY
Doing business as
IU Fort Wayne Lafayette Street Family Health Clinic
Practice address
2700 South Lafayette Street
Fort Wayne, IN 46806
Phone
(260) 744-3000
NPI assigned
Jun 6, 2007
Organization subpart
Yes
Parent organization
PURDUE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Authorized official

Name
Rebecca E Dixon, MBA, RRT
Title
Director of Patient Care Services
Phone
(317) 278-9059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X Primary

Addresses

Primary practice location

2700 South Lafayette Street
Fort Wayne, IN 46806

Mailing address

2700 S Lafayette Street
Suite 200
Fort Wayne, IN 46806
Phone (260) 481-0400

Other names 1

  • IU Fort Wayne Lafayette Street Family Health Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D1061322Lafayette Street Family Health Clinic2700 S Lafayette Street, Suite 200, Fort Wayne, IN 46806Provider-performed microscopyNov 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Indianapolis Eye Care C27 organizations share this tax ID, including this one
Part of
Trustees of University

Other organizations with this tax ID 26

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

View all 26

Locations

2700 Lafayette St
Ste 200
Fort Wayne, IN 46806
Phone (219) 456-6700

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": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1508069972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S LAFAYETTE STREET",
            "address_2": "SUITE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46806",
            "telephone_number": "260-481-0400",
            "fax_number": "765-496-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SOUTH LAFAYETTE STREET",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46806",
            "telephone_number": "260-744-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PURDUE UNIVERSITY",
        "enumeration_date": "2007-06-06",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT CARE SERVICES",
        "authorized_official_telephone_number": "317-278-9059",
        "authorized_official_credential": "MBA, RRT"
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Fort Wayne Lafayette Street Family Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.