Inphynet Primary Care Physicians Midwest, S.C.
Organization Active NPI Physician Assistant · Fort Wayne, IN
NPI 1528090610 · NPPES record last updated Jun 16, 2023
Key facts
- NPI
- 1528090610
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physician Assistant 363A00000X
- Legal business name
- INPHYNET PRIMARY CARE PHYSICIANS MIDWEST, S.C.
- Practice address
- 7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140 - Phone
- (260) 435-2699
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Elmer K Choi, MD
- Title
- Owner/President
- Phone
- (856) 686-4342
Practitioners 181
-
Paige S Ambrose, NP
-
Kristen M Bagot, NP
-
Catherine A Bailey, FNP-C
-
Krista B Bedenkop, FNP
-
Julia L Bouse, NP
-
Tori Dawn Clabaugh, FNP
-
Laura J Finn, FNP-C
-
Amanda Marie Fox, FNP-BC
-
Tiffany N Godfrey, APRN, FNP-C
-
Christina Anne Hamby, PNP
-
Lyndsey Hansen, NP
-
Jay Lee Hoeksema, NP
-
Kayla Leininger, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050525001352 | IN | Part B Supplier - Clinic/Group Practice | 6507808946 |
Receives reassigned benefits from 111 practitioners Practice locations: Warsaw, IN; Valparaiso, IN; Seymour, IN; Portage, IN; Peru, IN; Logansport, IN; La Porte, IN; Fort Wayne, IN… |
National Provider Directory
Locations
3929 E State Blvd
Fort Wayne, IN 46805
Phone (260) 435-7001
635407 Box
Cincinnati, OH 45263
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | |||
| Physician Assistant |
363A00000X | Yes | ||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Mailing address
Box 635407
Cincinnati, OH 45263-0001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE3669 | Other | IN | MEDICARE TRAVELERS RR-GA |
Other providers in Fort Wayne, IN
- Infinity Home Care Agency Inc.
- Infinity Home Health Care Services LLC
- Roberta D Ingol
- Innovative Hospital Care, LLC
- Innovative Professional Service LLC
- Inquest Health System PC
- Inquest Health System, PC
- Inquest MRI, LLC
- Instilling Hope Addiction Therapy, LLC
- Integrated Solutions LLC
All providers in Fort Wayne, IN · Physician Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.