GLADYS A. BEALE (NPI# 1164401063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164401063 |
| Entity Type | Individual |
| Full Name | GLADYS A. BEALE |
| Other Name | GLADYS A. BEALE-GANZHORN |
| Credential | M.D. |
| Practice Address |
1720 Beacon St Fort Wayne IN 46805-4749 |
| Mailing Address |
1234 E Dupont Rd Suite 1 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2603738000 |
| Practice Fax Number | 2603738034 |
| Mailing Telephone | 2603739700 |
| Mailing Fax Number | 2603739740 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2013-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
01052426A | IN | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
01052426A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RAILROAD MEDICARE | P00466953 | 01 |
| IN | ANTHEM | 000000543920 | 01 |
| RAILROAD MEDICARE | 260043528 | 01 | |
| IN | 200274420 | 05 | |
| OH | 2566067 | 05 |
| Street Address |
1720 BEACON ST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902432206 | Amy Silvers | Social Worker | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2020-03-18 |
| 1306472600 | Leah Ellen Hall | Counselor | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2020-03-18 |
| 1518425099 | Josie Jean Dean | Registered Nurse | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2019-03-04 |
| 1407342769 | Thomas Robert Smith | Pharmacist | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2018-07-10 |
| 1881148666 | Jacqueline Brandy Vedder | Marriage & Family Therapist | 1720 Beacon St, Fort Wayne, IN 46805 | 2016-08-09 |
| 1003369273 | Nicholas Todoran | Social Worker | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2016-07-25 |
| 1093168718 | Melinda Davis | Social Worker | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2016-07-18 |
| 1265880074 | Shawn Fingerle | Social Worker | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2016-06-02 |
| 1821459371 | Alexis Makridakis | Physician Assistant | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2016-03-11 |
| 1952779639 | Brittany Coffee | Nurse Practitioner | 1720 Beacon St, Fort Wayne, IN 46805-4749 | 2015-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487628855 | Helio C Perez | Psychiatry & Neurology | 2601 Cold Spring Rd, Indianapolis, IN 46222-2202 | 2006-02-14 |
| 1336439975 | John Mc Cauley Plewes II | Psychiatry & Neurology | 1400 W Raymond St, Code # 4113, Indianapolis, IN 46221-2004 | 2011-04-16 |
| 1982869830 | Suzanne Elaine Ducate | Psychiatry & Neurology | 7165 Clearvista Way, Indianapolis, IN 46256-4621 | 2008-07-21 |
| 1740320977 | Philip Meredith Coons | Psychiatry & Neurology | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-02-07 |
| 1033156880 | George F Parker | Psychiatry & Neurology | 1111 W 10th St, Indianapolis, IN 46202-4800 | 2006-06-01 |
| 1376504589 | Steven Harry Berger | Psychiatry & Neurology | 1258 Oak St, Suite B, Frankfort, IN 46041-3377 | 2006-03-29 |
| 1457348591 | Sajiv John | Psychiatry & Neurology | 601 Wall St, Valparaiso, IN 46383-2512 | 2005-10-04 |
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on GLADYS A. BEALE.
| 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.