NPIMap

Organization Active NPI

Pediatric Nursing Specialists of Indiana, Inc.

Doing business as Deaconess HomeCare

  • Home Health Agency
  • Fort Wayne, IN
National Provider Identifier
1992796619
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PEDIATRIC NURSING SPECIALISTS OF INDIANA, INC.
Doing business as
Deaconess HomeCare
Practice address
6523 Constitution Dr
Fort Wayne, IN 46804-1551
Phone
(260) 432-9699
Fax
(260) 432-5617
NPI assigned
Nov 2, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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
Miss Nancy C Jakus, RN BSN MBA
Title
Vice President of Operations
Phone
(601) 268-1842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

6523 Constitution Dr
Fort Wayne, IN 46804-1551

Mailing address

PO Box 16809
Hattiesburg, MS 39404-6809
Phone (601) 268-1842

Other names 1

  • Deaconess HomeCare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Deaconess Homecare3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992796619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16809",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394046809",
            "telephone_number": "601-268-1842",
            "fax_number": "601-268-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6523 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041551",
            "telephone_number": "260-432-9699",
            "fax_number": "260-432-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NURSING SPECIALISTS OF INDIANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAKUS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "601-268-1842",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN BSN MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess HomeCare",
            "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.