Active NPI
Mallers & Swoverland Orthopaedic Physical Therapy
- Physical Therapist
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- MALLERS & SWOVERLAND ORTHOPAEDIC PHYSICAL THERAPY
- Practice address
- 9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095 - Phone
- (260) 489-9887
- Fax
- (260) 489-9121
- NPI assigned
- Nov 23, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Douglas Mallers, P.T.
- Title
- Therapist/Owner
- Phone
- (260) 489-9887
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095
Mailing address
9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095
Phone (260) 489-9887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CJ8713 | Other | IN | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041030000203 | IN | Part B Supplier - Clinic/Group Practice | 2961464169 |
Receives reassigned benefits from 14 practitioners Practice locations: Fort Wayne, IN |
National Provider Directory
National Provider DirectoryLocations
9039 Stellhorn Crossing Pkwy
Fort Wayne, IN 46815
Phone (260) 489-9727
7611 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-8454
9602 Coldwater Rd
Fort Wayne, IN 46825
Phone (260) 489-9887
9602 Coldwater Rd
Ste 102
Fort Wayne, IN 46825
Phone (260) 489-9887
7617 W Jefferson Blvd
Ste D
Fort Wayne, IN 46804
Phone (260) 436-8454
Practitioners & affiliated clinicians
Practitioners 19
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Columbia City, IN
- NPI 1184930240
IN, Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1690848000000",
"number": "1700869732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9602 COLDWATER RD",
"address_2": "SUITE 102",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468252095",
"telephone_number": "260-489-9887",
"fax_number": "260-489-9121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9602 COLDWATER RD",
"address_2": "SUITE 102",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468252095",
"telephone_number": "260-489-9887",
"fax_number": "260-489-9121"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MALLERS & SWOVERLAND ORTHOPAEDIC PHYSICAL THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-23",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A",
"authorized_official_last_name": "MALLERS",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_title_or_position": "THERAPIST/OWNER",
"authorized_official_telephone_number": "260-489-9887",
"authorized_official_credential": "P.T."
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CJ8713",
"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 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.