Community Living Resources LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

COMMUNITY LIVING RESOURCES LLC

Practice address

2927 Lake Ave
Fort Wayne, IN 46805-5415

Phone

(260) 745-1200

Fax

(260) 745-5968

NPI assigned

Jun 17, 2015

Organization subpart

No

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

Authorized official

Name

Aaron Shapiro

Title

Cfo

Phone

(260) 745-1200

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 7

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

• Suresh Jaiswal, M.D.

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1962635755
  Medicare reassignment NPD
• Kelly Zolman, NP

  • Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1730985144
  Medicare reassignment NPD
• Kristine Elizabeth Davis, FNP-BC, FNP-C

  • Family Nurse Practitioner
  • Goshen, IN
  • NPI 1275916264
  Medicare reassignment
• Susan Rebekah Defrain, NP-C

  • Gerontology Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1174064562
  Medicare reassignment
• Debra Ann Fiechter, RN, FNP

  • Family Nurse Practitioner
  • Berne, IN
  • NPI 1437491925
  Medicare reassignment
• Jennifer Carol Littke, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1922470970
  Medicare reassignment
• Frederica Ann Nodine, NP-C

  • Family Nurse Practitioner
  • Bluffton, IN
  • NPI 1316176258
  Medicare reassignment

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517529600000",
    "number": "1780065425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055415",
            "telephone_number": "260-745-1200",
            "fax_number": "260-745-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055415",
            "telephone_number": "260-745-1200",
            "fax_number": "260-745-5968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIVING RESOURCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2018-02-02",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "260-745-1200"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Jo Comment
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• Community Open MRI of Auburn LLC
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• Compass Counseling, LLC
• Compassion 360 Home Care LLC
• Compassionate Care Homes LLC

• In Home Supportive Care Agency in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• In Home Supportive Care Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; 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.

Verify at the official NPI Registry.