Connie J Lubbehusen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10000811A Issued in IN

Practice address

920 E Coliseum Blvd
Fort Wayne, IN 46805-1329

Phone

(260) 498-8077

NPI assigned

Nov 20, 2006

Sex

Female

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

Credentials

Physician Assistant

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.

• Emergency Medicine of Indiana

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1952356883
  NPD (past)
• Innovative Hospital Care Inc

  • Hospitalist Physician
  • Peru, IN
  • NPI 1427298330
  NPD (past)
• Phoenix Emergency Physicians of the Midwest LLC

  • Emergency Medicine Physician
  • Van Wert, OH
  • NPI 1144556184
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1659445641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051329",
            "telephone_number": "260-498-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBBEHUSEN",
        "first_name": "CONNIE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000811A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Marie Lowry, MA
• Kylie Rae Lowry, LMFT
• Nikya Lowry
• LS2 Ventures LLC
• Michael Joseph Luarde, D.D.S.
• Stephen Lubbehusen, ATC,LAT
• Yvonne C Lubia, MD
• Sophia Lubrin, MD
• David Paul Lubs, OD
• Kobe Joseph Lucarelli I

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.