Directclinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DIRECTCLINIC LLC

Practice address

7802 W Jefferson Blvd
Fort Wayne, IN 46804-4138

Phone

(260) 466-5671

NPI assigned

Dec 29, 2016

Last updated

Dec 29, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

DIRECTCARE LLCAs reported in NPPES

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

Authorized official

Name

Mr. Sudhakar Krishnan

Title

President & Ceo

Phone

(260) 212-1900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1710422746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 W JEFFERSON BLVD",
            "address_2": "SUITE 176",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046203",
            "telephone_number": "260-212-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7802 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044138",
            "telephone_number": "260-466-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECTCLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIRECTCARE LLC",
        "enumeration_date": "2016-12-29",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "KRISHNAN",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "260-212-1900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmalou Dinken, RNC NP
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• Cynthia Dirig, RN-BSN
• Levi Edward Lynn Dirig
• Melanie Dirig
• Brett Michael Disalle, DDS

• Primary Care Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.