Active NPI
Emalese Rose Fuelling, DPT
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1518334697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05011891A
- Practice address
- 3840 New Vision Dr
Fort Wayne, IN 46845-1708 - Phone
- (260) 483-2422
- Fax
- (260) 471-0788
- NPI assigned
- Aug 25, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05011891A | IN | Primary |
Addresses
Primary practice location
3840 New Vision Dr
Fort Wayne, IN 46845-1708
Mailing address
3840 New Vision Dr
Fort Wayne, IN 46845-1708
Phone (260) 483-2422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05011891A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440460800000",
"number": "1518334697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3840 NEW VISION DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451708",
"telephone_number": "260-483-2422",
"fax_number": "260-471-0788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3840 NEW VISION DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451708",
"telephone_number": "260-483-2422",
"fax_number": "260-471-0788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUELLING",
"first_name": "EMALESE",
"middle_name": "ROSE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-25",
"last_updated": "2015-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05011891A",
"primary": true
}
],
"identifiers": [],
"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 Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.