Tara Marie Meyer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05009664A Issued in IL

Practice address

3534 Brooklyn Ave
Fort Wayne, IN 46809-1361

Phone

(260) 478-5230

Fax

(260) 478-5235

NPI assigned

Jul 1, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Indiana Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Bluffton, IN
  • NPI 1629110192

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1902068828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 LAHMEYER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468155676",
            "telephone_number": "260-432-4700",
            "fax_number": "260-459-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3534 BROOKLYN AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468091361",
            "telephone_number": "260-478-5230",
            "fax_number": "260-478-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "05009664A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "100257920",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "156546",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Meyer, PT, DPT
• Marissa Meyer
• Michael E Meyer, NP
• Michelle Meyer
• Mitchell Kory Meyer, AT, ATC
• Holly Meyers
• MGFW Surgery Center, LLC
• Nda Bukhosi Mhlophe, M.D.
• Michael J Phend, MD
• Michael J. Bangert O.D. Inc.

• Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.