Lincoln Pedic Clinic, Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

07000776A Issued in IN

Legal business name

LINCOLN PEDIC CLINIC, INC.

Practice address

12311 Autumn Breeze Dr
Fort Wayne, IN 46845-9111

Phone

(260) 637-8414

Fax

(260) 637-8152

NPI assigned

Jun 10, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Janet Alyce Paunwar

Title

President

Phone

(260) 637-8414

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

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

• Michael C McManus, DPM

  • Podiatrist
  • Fort Wayne, IN
  • NPI 1689673766
  NPD (past)
• Karen F Sloane, D.P.M.

  • Podiatrist
  • Fort Wayne, IN
  • NPI 1124021100
  NPD (past)

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1760486393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 AUTUMN BREEZE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459111",
            "telephone_number": "260-637-8414",
            "fax_number": "260-637-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 AUTUMN BREEZE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459111",
            "telephone_number": "260-637-8414",
            "fax_number": "260-637-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PEDIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "PAUNWAR",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "ALYCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-637-8414",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000776A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000235683",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100210380A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "C31367",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jill R Linder, O.T.
• Jacqueline Lindley
• Lindsay M. Mack Chiropractic, LLC
• Lindsey Anderson Counseling LLC
• Manuela Lindsey, COTA

• Podiatrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.