Individual provider Active NPI

Sarah E Brandenberger, MS, CGC

  • Genetic Counselor (M.S.)
  • Fort Wayne, IN
National Provider Identifier
1942696356
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
74000081A Issued in IN
Practice address
11115 Parkview Plaza Dr
Attn: Sarah King
Fort Wayne, IN 46845-1701
Phone
(260) 266-8271
Fax
(260) 266-8271
NPI assigned
Apr 13, 2015
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 74000081A IN Primary

Addresses

Primary practice location

11115 Parkview Plaza Dr
Attn: Sarah King
Fort Wayne, IN 46845-1701

Mailing address

3926 New Vision Dr BLDG H
Fort Wayne, IN 46845-1712
Phone (260) 373-9728

Other identifiers 2

IdentifierTypeStateIssuer
74000081AOtherINPROFESSIONAL LICENSING AGENCY OF INDIANA
123869OtherINNATIONAL SOCIETY OF GENETIC COUNSELORS

Other names 1

  • Sarah E King Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
74000081AINMDGenetic Counselor (M.S.)

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1942696356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3926 NEW VISION DR BLDG H",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451712",
            "telephone_number": "260-373-9728",
            "fax_number": "260-458-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 PARKVIEW PLAZA DR",
            "address_2": "ATTN: SARAH KING",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-266-8271",
            "fax_number": "260-266-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBERGER",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "MS, CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "IN",
            "license": "74000081A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSING AGENCY OF INDIANA",
            "identifier": "74000081A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL SOCIETY OF GENETIC COUNSELORS",
            "identifier": "123869",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "KING",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 4, 2017; 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.