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EVERSIDE HEALTH FORT WAYNE-W LUDWIG RD NPI 1861880890


NPI Information

NPI: 1861880890
Provider Name: EVERSIDE HEALTH FORT WAYNE-W LUDWIG RD
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 15D2078214

Address:
2932 W LUDWIG RD
FORT WAYNE, IN
ZIP 46818
Phone: (260) 755-1304
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EVERSIDE HEALTH FORT WAYNE-W LUDWIG RD is a primary care clinic center in Fort Wayne, IN. EVERSIDE HEALTH FORT WAYNE-W LUDWIG RD NPI is 1861880890. The provider is registered as an organization entity type.

The provider's business location address is:

2932 W LUDWIG RD
FORT WAYNE, IN
ZIP 46818-328
Phone: (260) 755-1304
Fax: (260) 755-1306

The provider's authorized official is Jill Johnson Patton .
The authorized official title is Director Of Risk Management and has the following contact phone number (704) 936-5546.

The CLIA number assigned to this NPI record is 15D2078214 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/29/2014 and was last updated on 8/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.