Beth A Lundblad, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05003635 Issued in IN

Practice address

7333 W Jefferson Blvd
Fort Wayne, IN 46804-6280

Phone

(260) 435-6230

Fax

(260) 435-7747

NPI assigned

Sep 26, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Redimed Dekalb LLC

  • General Practice Physician
  • Auburn, IN
  • NPI 1669417457

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932200706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 PRINCETON AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081915",
            "telephone_number": "260-471-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7333 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046280",
            "telephone_number": "260-435-6230",
            "fax_number": "260-435-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBLAD",
        "first_name": "BETH",
        "middle_name": "A",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05003635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen D Lugo, M.D.
• Lauren Luley, EDS, BCBA
• Lumen Orthotics & Prosthetics
• Luminary Hospice of Fort Wayne, LLC
• Catherine Lumma
• Beck Michael Lundeen
• Hannah Lynn Lundy, OTD, OTR/L
• Katharine Lundy, PHARMD
• Meghan Lundy, MS, LCGC
• Alexandra Lung, RBT

• 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 Jul 8, 2007; 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.