Organization Active NPI

Fort Wayne Allergy and Asthma Consultants, Inc.

  • Allergy & Immunology Physician
  • Fort Wayne, IN
National Provider Identifier
1689714727
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
FORT WAYNE ALLERGY AND ASTHMA CONSULTANTS, INC.
Practice address
7920 W Jefferson Blvd
Suite 220
Fort Wayne, IN 46804-4168
Phone
(260) 436-5670
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lyn Wittwer
Title
Office Manager
Phone
(260) 436-5670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

7920 W Jefferson Blvd
Suite 220
Fort Wayne, IN 46804-4168

Mailing address

7920 W Jefferson Blvd
Suite 220
Fort Wayne, IN 46804-4168
Phone (260) 436-5670

Other identifiers 1

IdentifierTypeStateIssuer
200291770AMedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Fort Wayne Allergy and Asthma Consultants Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7920 W Jefferson Blvd
Ste 220
Fort Wayne, IN 46804
Phone (260) 436-5670

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689714727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 W JEFFERSON BLVD",
            "address_2": "SUITE 220",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044168",
            "telephone_number": "260-436-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 W JEFFERSON BLVD",
            "address_2": "SUITE 220",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044168",
            "telephone_number": "260-436-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE ALLERGY AND ASTHMA CONSULTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WITTWER",
        "authorized_official_first_name": "LYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "260-436-5670"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200291770A",
            "state": "IN"
        }
    ],
    "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 22, 2020; 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.