Anita Louise Doctor, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71002180A Issued in IN

Practice address

14303 W Cedar Lake Dr
Fort Wayne, IN 46845-9642

Phone

(260) 438-8863

NPI assigned

Jul 27, 2006

Last updated

Mar 17, 2018By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rounding Providers

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1538486691
  Medicare reassignment NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  dba Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment NPD
• DHHS PHS Naihs Chinle Comprehensive

  dba Chinle Comprehenive Health Care Facility

  • Ambulatory Surgical Clinic/Center
  • Chinle, AZ
  • NPI 1922253129
  NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  dba Tsaile Health Center

  • General Acute Care Hospital
  • Tsaile, AZ
  • NPI 1538185715
  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1740204270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14303 W CEDAR LAKE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459642",
            "telephone_number": "260-438-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14303 W CEDAR LAKE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459642",
            "telephone_number": "260-438-8863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 W Jefferson Blvd",
            "address_2": "Suite 304",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044128",
            "country_code": "US",
            "telephone_number": "260-969-6200",
            "fax_number": "260-969-6201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOCTOR",
        "first_name": "ANITA",
        "middle_name": "LOUISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002180A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000490404",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Dobbins, AGNP
• Edward D Dobson, LCSW
• Pyper Dobson, DPT
• Raigyn Dobson, RBT
• Doctor Eady Family Dentistry, P.C.
• Kortney Michelle Dodge, FNP-C
• Erin Dodson, NP
• Janiyah Dodson
• Riley Dodson
• Amaya Doehrman, RBT

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.