NPIMap

Organization Active NPI

Kenneth a. Bundza and Sherwin Y. Kepes

  • Psychologist
  • Fort Wayne, IN
National Provider Identifier
1942369194
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20010242A Issued in IN
Legal business name
KENNETH A. BUNDZA AND SHERWIN Y. KEPES
Doing business as
The Consulting Center
Practice address
6026 E State Blvd
Fort Wayne, IN 46815-7639
Phone
(260) 749-8419
Fax
(260) 749-0553
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kenneth A. Bundza, PH.D.
Title
Partner
Phone
(260) 749-8419

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 20010242A IN Primary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 20010117A IN

Addresses

Primary practice location

6026 E State Blvd
Fort Wayne, IN 46815-7639

Mailing address

6026 E State Blvd
Fort Wayne, IN 46815-7639
Phone (260) 749-8419

Other names 1

  • The Consulting Center Doing business as

National Provider Directory

National Provider Directory

Locations

6026 E State Blvd
Fort Wayne, IN 46815
Phone (260) 749-8419

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942369194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6026 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157639",
            "telephone_number": "260-749-8419",
            "fax_number": "260-749-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6026 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157639",
            "telephone_number": "260-749-8419",
            "fax_number": "260-749-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A. BUNDZA AND SHERWIN Y. KEPES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUNDZA",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "260-749-8419",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20010242A",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20010117A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Consulting Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.