SPINE TECHNOLOGY AND REHABILITATION PC (NPI# 1295905529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295905529 |
| Entity Type | Organization |
| Organization Name | SPINE TECHNOLOGY AND REHABILITATION PC |
| Practice Address |
3898 New Vision Dr Suite B Fort Wayne IN 46845-1718 |
| Practice Telephone | 2604597313 |
| Practice Fax Number | 2604360628 |
| Mailing Telephone | 2604597313 |
| Mailing Fax Number | 2604360628 |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2011-01-11 |
| Authorized Official Name | JOSEPH FORTIN (PHYSICIAN OWNER) |
| Authorized Official Telephone | 2604597313 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
3898 NEW VISION DR SUITE B |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013936814 | Michael Philip Dick | Pediatrics | 3898 New Vision Dr, Fort Wayne, IN 46845 | 2006-07-19 |
| 1982089371 | Kelsey Darmochwal | Counselor | 3898 New Vision Dr, Suite E, Fort Wayne, IN 46845-1718 | 2015-07-27 |
| 1821411331 | Colleen Mccracken | Physical Therapist | 3898 New Vision Dr, Bldg 13, Suite D, Fort Wayne, IN 46845-1718 | 2014-02-04 |
| 1760812259 | Everyday Counseling & Services LLC | Counselor | 3898 New Vision Dr, Bldg #13 Suite #e, Fort Wayne, IN 46845-1718 | 2013-11-19 |
| 1760828073 | Rhonda Leigh Anderson | Nurse Practitioner | 3898 New Vision Dr, Fort Wayne, IN 46845 | 2013-05-14 |
| 1073750741 | Sayed E. Wahezi | Physical Medicine & Rehabilitation | 3898 New Vision Dr, Suite B, Fort Wayne, IN 46845-1718 | 2009-01-16 |
| 1265606065 | Amy Sue Hancher | Registered Nurse | 3898 New Vision Dr, Fort Wayne, IN 46845 | 2008-04-14 |
| 1558469973 | Tonya Windsor | Specialist | 3898 New Vision Dr, Ste D, Fort Wayne, IN 46845-1718 | 2006-09-20 |
| 1508962028 | Heather D Christlieb | Specialist | 3898 New Vision Dr, Ste D, Fort Wayne, IN 46845-1718 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467423939 | Mark V Reecer | Physical Medicine & Rehabilitation | 5750 Coventry Ln, Suite 101, Fort Wayne, IN 46804-7166 | 2006-01-31 |
| 1083833297 | Allied Physicians Inc | Physical Medicine & Rehabilitation | 5750 Coventry Ln, Suite 101, Fort Wayne, IN 46804-7166 | 2007-04-25 |
| 1649370958 | Alfred Francis Allina | Physical Medicine & Rehabilitation | 4656 W Jefferson Blvd, Suite 250, Fort Wayne, IN 46804-6857 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932683471 | New Wellspring LLC | Physical Medicine & Rehabilitation | 2400 Northpark Dr Ste 20, Columbus, IN 47203-4467 | 2018-09-20 |
| 1003247008 | Advancd Pain and Rehab Md LLC | Physical Medicine & Rehabilitation | 1443 S Lake Park Ave, Hobart, IN 46342-6635 | 2013-12-02 |
| 1639454440 | Merrillville Pain Relief Center PC | Physical Medicine & Rehabilitation | One Tower Plaza, 111 E 89th Avenue, Ste 111, Merrillville, IN 46410-7184 | 2011-10-13 |
| 1639211808 | Joseph William Bergeron | Physical Medicine & Rehabilitation | 9292 N Meridian St Ste 111, Indianapolis, IN 46260-1828 | 2007-02-13 |
| 1861542565 | Ofelia Balagtas-balmaseda | Physical Medicine & Rehabilitation | 4812 S 7th St, Terre Haute, IN 47802-4502 | 2007-01-12 |
| 1548352727 | Choong Jin Yoon | Physical Medicine & Rehabilitation | 600 Saint Andrews Dr, Schererville, IN 46375-2970 | 2006-09-28 |
| 1669425419 | Heartland Physical Medicine & Rehabilitation PC | Physical Medicine & Rehabilitation | 1019 E Springhill Dr, Terre Haute, IN 47802 | 2006-05-19 |
| 1730130402 | Robert K Silbert | Physical Medicine & Rehabilitation | 6640 Parkdale Pl, Suite R, Indianapolis, IN 46254-5619 | 2006-05-15 |
| 1295732055 | Steven A Rupert | Physical Medicine & Rehabilitation | 2330 Lynch Rd, Suite 100, Evansville, IN 47711-2998 | 2005-07-07 |
| 1144227596 | Irving I. Haber | Physical Medicine & Rehabilitation | 1818 N 3rd St, Terre Haute, IN 47804-4041 | 2005-06-30 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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| 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.