NPIMap

Organization Active NPI

Parkview Wabash Hospital, Inc.

Doing business as Parkview Wabash Multi-Specialty Physicians' Group

  • Family Medicine Physician
  • Wabash, IN
National Provider Identifier
1891176590
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PARKVIEW WABASH HOSPITAL, INC.
Doing business as
Parkview Wabash Multi-Specialty Physicians' Group
Practice address
10 John Kissinger Dr.
Wabash, IN 46992-1648
Phone
(260) 563-3131
NPI assigned
Jun 18, 2015
Last updated
Jun 27, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PARKVIEW WABASH HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Authorized official

Name
Jeanne Wickens
Title
Cfo
Phone
(260) 266-9313

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

10 John Kissinger Dr.
Wabash, IN 46992-1648

Mailing address

10501 Corporate Dr
Fort Wayne, IN 46845-1700
Phone (260) 373-8406

Other practice location 1

8 John Kissinger Drive
Wabash, IN 46992-1648
Phone (260) 563-7421

Other practice location 2

1104 N Wayne St
North Manchester, IN 46962-1001
Phone (260) 982-2102

Other practice location 3

1655 N Cass St
Wabash, IN 46992-9416
Phone (260) 569-2302

Other practice location 4

710 N East St
Wabash, IN 46992-1914
Phone (260) 563-3131

Other names 1

  • Parkview Wabash Multi-Specialty Physicians' Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181128002503 IN Part B Supplier - Clinic/Group Practice 0244553360 Receives reassigned benefits from 91 practitioners
Practice locations: North Manchester, IN; Wabash, IN

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Parkview Wabash Hospital Inc

Locations

10 John Kissinger Dr
Wabash, IN 46992
Phone (260) 424-2195

8 John Kissinger Dr
Wabash, IN 46992
Phone (260) 563-7421

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Parkview Wabash Health Clinic - North ManchesterNorth Manchester, IN, CCN 158541 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 1, 2018
Jan 1, 2018
Parkview Wabash Health Clinic - Kissinger DriveWabash, IN, CCN 158542 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 1, 2018
Jan 1, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1891176590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 CORPORATE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451700",
            "telephone_number": "260-373-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 JOHN KISSINGER DR.",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921648",
            "telephone_number": "260-563-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 John Kissinger Drive",
            "address_purpose": "LOCATION",
            "city": "Wabash",
            "state": "IN",
            "postal_code": "469921648",
            "country_code": "US",
            "telephone_number": "260-563-7421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1104 N Wayne St",
            "address_purpose": "LOCATION",
            "city": "North Manchester",
            "state": "IN",
            "postal_code": "469621001",
            "country_code": "US",
            "telephone_number": "260-982-2102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1655 N Cass St",
            "address_purpose": "LOCATION",
            "city": "Wabash",
            "state": "IN",
            "postal_code": "469929416",
            "country_code": "US",
            "telephone_number": "260-569-2302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 N East St",
            "address_purpose": "LOCATION",
            "city": "Wabash",
            "state": "IN",
            "postal_code": "469921914",
            "country_code": "US",
            "telephone_number": "260-563-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARKVIEW WABASH HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARKVIEW WABASH HOSPITAL, INC.",
        "enumeration_date": "2015-06-18",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "WICKENS",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "260-266-9313"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkview Wabash Multi-Specialty Physicians' Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Parkview Wabash Multi-Specialty Physicians' Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wabash, IN

Sources for this page

Verify at the official NPI Registry.