NPIMap

Organization Active NPI

Matthew 25, Inc

  • Primary Care Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1992268635
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MATTHEW 25, INC
Practice address
413 E Jefferson Blvd
Fort Wayne, IN 46802-3201
Phone
(260) 426-3250
NPI assigned
Apr 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Samantha Glover
Title
HR
Phone
(260) 426-3250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

413 E Jefferson Blvd
Fort Wayne, IN 46802-3201

Mailing address

413 E Jefferson Blvd
Fort Wayne, IN 46802-3201
Phone (260) 426-3250

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0885928Matthew 25 Health & Dental Clinic413 E Jefferson Blvd, Fort Wayne, IN 46802Certificate of waiverMar 13, 2027

National Provider Directory

National Provider Directory

Locations

413 E Jefferson Blvd
Fort Wayne, IN 46802
Phone (260) 426-3250

Practitioners & affiliated clinicians

Practitioners 7

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": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1992268635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 E JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023201",
            "telephone_number": "260-426-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023201",
            "telephone_number": "260-426-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW 25, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "260-426-3250"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "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 Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.