NPIMap

Organization Active NPI

North Node Wellness, Inc.

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1942622865
Registry record updated Jan 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005563A Issued in IN
Legal business name
NORTH NODE WELLNESS, INC.
Practice address
8701 Waterwood CT
Fort Wayne, IN 46804-8410
Phone
(260) 705-4395
NPI assigned
Jan 11, 2014
Last updated
Jan 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2014

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

Authorized official

Name
Kimberly A Bailey, LCSWNPI 1295256907
Title
Owner, Ceo
Phone
(260) 705-4395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005563A IN Primary

Addresses

Primary practice location

8701 Waterwood CT
Fort Wayne, IN 46804-8410

Mailing address

8701 Waterwood CT
Fort Wayne, IN 46804-8410
Phone (260) 705-4395

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389398400000",
    "number": "1942622865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 WATERWOOD CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468048410",
            "telephone_number": "260-705-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 WATERWOOD CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468048410",
            "telephone_number": "260-705-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH NODE WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-11",
        "last_updated": "2014-01-11",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "260-705-4395",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005563A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 11, 2014; 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.