NPIMap

Organization Active NPI

Possibilities Northeast, LLC.

  • Speech-Language Pathologist
  • Fort Wayne, IN
National Provider Identifier
1881734697
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
POSSIBILITIES NORTHEAST, LLC.
Practice address
4935 Hillegas Rd Ste 200
Fort Wayne, IN 46818-1934
Phone
(260) 338-1241
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Authorized official

Name
Nancy L Moore
Title
Executive Director
Phone
(260) 338-1241

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Pediatric Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0200X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary
Day Training/Habilitation SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 373H00000X

Addresses

Primary practice location

4935 Hillegas Rd Ste 200
Fort Wayne, IN 46818-1934

Mailing address

PO Box 80867
Fort Wayne, IN 46898-0867

Other identifiers 5

IdentifierTypeStateIssuer
200354340AMedicaidIN
200435950AMedicaidIN
200724290AMedicaidIN
200357910AMedicaidIN
200724290MedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Possibilities Northeast2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2821 Hillegas Rd
Fort Wayne, IN 46808
Phone (260) 471-1950

2825 Hillegas Rd
Fort Wayne, IN 46808
Phone (260) 585-7655

4935 Hillegas Rd
Ste 200
Fort Wayne, IN 46818

9031 Stellhorn Crossing Pkwy
Fort Wayne, IN 46815
Phone (260) 316-4634

Practitioners & affiliated clinicians

Practitioners 228

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

View all 228

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1881734697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80867",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468980867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 HILLEGAS RD STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468181934",
            "telephone_number": "260-338-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSSIBILITIES NORTHEAST, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "260-338-1241"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200354340A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200435950A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200724290A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200357910A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200724290",
            "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 Feb 26, 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.