LAFAYETTE FOOT AND ANKLE CLINIC (NPI# 1003099441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003099441 |
| Entity Type | Organization |
| Organization Name | LAFAYETTE FOOT AND ANKLE CLINIC |
| Practice Address |
2700 Lafayette St Ste 230 Fort Wayne IN 46806-1100 |
| Practice Telephone | 2604589953 |
| Practice Fax Number | 2604589238 |
| Mailing Telephone | 2604589953 |
| Mailing Fax Number | 2604589238 |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |
| Authorized Official Name | DR. BENNY FAIR JR. (OWNER) |
| Authorized Official Telephone | 2604589953 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
07000728 | IN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MCR | P00128864 | 01 |
| Street Address |
2700 LAFAYETTE ST STE 230 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46806-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841574829 | Daniel E Purvis Jr. | Pharmacist | 222 E Pettit Avenue, Fort Wayne, IN 46806 | 2011-10-07 |
| 1558645754 | Logan M Franke | Pharmacist | 222 E Pettit Ave, Fort Wayne, IN 46806 | 2011-10-06 |
| 1356513725 | Seazoned Med Transportation Service | Non-emergency Medical Transport (VAN) | 2809 Smith Street, Fort Wayne, IN 46806 | 2008-03-26 |
| 1376711267 | Hector F Perez Md PC | Family Medicine | 5717 So Anthony, Ste 500, Fort Wayne, IN 46806 | 2008-02-14 |
| 1326249376 | Purdue University | Dentist | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-05-29 |
| 1174657480 | Robert Anthony Ford | Case Manager/Care Coordinator | 525 Oxford St., Fort Wayne, IN 46806 | 2007-03-16 |
| 1508069972 | Indiana University | Clinic/Center | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-06-06 |
| 1669622403 | Sally J Hartman | Nurse Practitioner | 2700 S Lafayette St, Suite 200, Fort Wayne, IN 46806-1100 | 2008-09-30 |
| 1033259197 | V E Butler and Associates PC | Pharmacist | 2700 S. Lafayette St, Communitycare Pharmacy, Fort Wayne, IN 46806-1100 | 2007-02-07 |
| 1053376186 | Rebecca Konkin | Nurse Practitioner | 2700 Lafayette St, Ste B-10, Fort Wayne, IN 46806-1100 | 2006-04-20 |
| Find all providers in zip 46806 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922240019 | Robert E. Wyatt | Podiatrist | 9134 Bradenton Rd, Fort Wayne, IN 46835-8892 | 2009-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447784012 | Mohammed Ahmeduddin, LLC | Podiatrist | 11661 Archer Ln, Fishers, IN 46037-3201 | 2017-04-20 |
| 1306295084 | Melanie S. Kocevar | Podiatrist | 2003 Stults Rd Ste 200, Huntington, IN 46750-1291 | 2016-06-03 |
| 1457732133 | Angelic Footcare | Podiatrist | 8785 Keystone Xing, 1268, Indianapolis, IN 46240-2337 | 2015-06-17 |
| 1528317518 | Jerwana Laster | Podiatrist | 10935 Beechwood Dr E, Indianapolis, IN 46280-1222 | 2012-09-05 |
| 1881955664 | Manjit Kaur | Podiatrist | 301 Satori Pkwy Ste 150, Avon, IN 46123-6408 | 2012-06-07 |
| 1801066691 | Dr. Thomas V. Tsoutsouris | Podiatrist | 1403 Franklin St, Michigan City, IN 46360-3707 | 2008-03-07 |
| 1285804070 | Dr. Thomas V. Tsoutsouris | Podiatrist | 7330 Indianapolis Blvd Ste 3, Hammond, IN 46324-2945 | 2008-03-07 |
| 1376749168 | Srd Podiatry P.C. | Podiatrist | 1237 W. 82nd Lane, Merrillville, IN 46410 | 2007-06-27 |
| 1003031204 | Dr N W Worden PC | Podiatrist | 2206 Lincolnway E, Mishawaka, IN 46544-3301 | 2007-04-15 |
| 1487704680 | Mann Spitler IIi | Podiatrist | 3104 Churchview Dr, Valparaiso, IN 46383-2433 | 2007-01-11 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46806 |
Please comment or provide details below to improve the information on LAFAYETTE FOOT AND ANKLE CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.