Active NPI
Renuka Indlamuri
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1891097044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05010214A
- Practice address
- 2940 N Clinton St
Fort Wayne, IN 46805-1910 - Phone
- (260) 484-0602
- NPI assigned
- Nov 21, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05010214A | IN | Primary |
Addresses
Primary practice location
2940 N Clinton St
Fort Wayne, IN 46805-1910
Mailing address
10120 Jefferson Way
Fort Wayne, IN 46825-2178
Phone (571) 420-2030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05010214A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290297600000",
"number": "1891097044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10120 JEFFERSON WAY",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468252178",
"telephone_number": "571-420-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 N CLINTON ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468051910",
"telephone_number": "260-484-0602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDLAMURI",
"first_name": "RENUKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-21",
"last_updated": "2010-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05010214A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
- Indiana University Health Urgent Care Centers, LLC (IU Health Urgent Care Centers, LLC)
- Indiana University Health Urgent Care Centers, LLC (IU Health Urgent Care Centers, LLC)
- Indiana Vision Development Center II LLC
- Indiana Vision Development Center PC
- Indiana Wound Care, P.C.
- Infectious Disease Associates, P.C.
- Infinite Abilities LLC
- Infinite Journey, LLC
- Infinity Home Care Agency Inc.
- Infinity Home Health Care Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.