SUPER SHOT (NPI# 1427373372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427373372 |
| Entity Type | Organization |
| Organization Name | SUPER SHOT |
| Practice Address |
709 Clay St Suite 300 Fort Wayne IN 46802-2019 |
| Practice Telephone | 2604247468 |
| Mailing Telephone | 2604247468 |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-06-24 |
| Authorized Official Name | KELLY ZACHRICH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2604247468 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | N/A | IN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200977620A | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | SUPER SHOT PHOTOGRAPHY, INC | 10531 Lieter Place, Lone Tree, CO 80124 |
| Indiana Business Entities | SUPER SHOT, INC. | 709 Clay St., Ste 300, Ft. Wayne, IN 46802 |
| Street Address |
709 CLAY ST SUITE 300 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46802-2019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084416 | Renaissance Counseling Center,llc | Community/Behavioral Health | 1210 Guthrie St, Fort Wayne, IN 46802 | 2020-05-14 |
| 1699260182 | Tina Huffman Counseling Services LLC | Clinic/Center | 2323 111 W. Berry St., Fort Wayne, IN 46802 | 2018-06-27 |
| 1669879664 | Neighborhood Health Clinics, Inc | Clinic/Center | 1721 S Calhoun St, Fort Wayne, IN 46802 | 2014-11-20 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1174899405 | Hearcare Connection, Inc. | Audiologist | 130 W Main St Ste 150, Fort Wayne, IN 46802 | 2012-03-30 |
| 1801114533 | Hoosier Sports & Chiropractic LLC | Chiropractor | 122 W Wayne Street, Fort Wayne, IN 46802 | 2010-05-05 |
| 1891912523 | Krista Lohmar | Speech-Language Pathologist | 3340 North Washington Road, Ft. Wayne, IL 46802 | 2007-04-20 |
| 1811047608 | Catholic Charities of The Diocese of Fort Wayne-south Bend, Inc. | Counselor | 915 South Clinton, Fort Wayne, IN 46802 | 2007-01-12 |
| 1548323801 | Clifford T Salk | Dentist | 122 W Washington Blvd, Fort Wayne, IN 46802 | 2006-12-18 |
| 1720155492 | Kristina Wise | Social Worker | 203 W Wayne St Ste 317, Fort Wayne, IN 46802 | 2006-11-29 |
| Find all providers in zip 46802 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649422668 | Ft. Wayne-allen County Department of Health | Public Health or Welfare | 200 E Berry St., Suite 360, Fort Wayne, IN 46802-2738 | 2008-10-22 |
| 1841534914 | Indiana Physical Therapy Inc | Public Health or Welfare | 2101 E Coliseum Blvd, Fort Wayne, IN 46805-1445 | 2012-11-15 |
| 1932386364 | Frank Robinson Jr Od PC | Public Health or Welfare | 6710 Old Trail Rd, Fort Wayne, IN 46809-2639 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962243 | Laustin Company, LLC | Public Health or Welfare | 5144 E Stop 11 Rd Ste 24, Indianapolis, IN 46237-8606 | 2020-08-14 |
| 1598389991 | Indiana Immunization Coalition | Public Health or Welfare | 9355 N 400 W, Fountaintown, IN 46130-9763 | 2020-06-01 |
| 1942836606 | Dekalb County | Public Health or Welfare | 220 E 7th St Ste 110, Auburn, IN 46706-1899 | 2020-03-13 |
| 1992342562 | Steuben County Auditor | Public Health or Welfare | 317 S Wayne St Ste 3a, Angola, IN 46703-1958 | 2019-12-03 |
| 1689138794 | Sds Counseling LLC | Public Health or Welfare | 590 Missouri Ave Ste 206f, Jeffersonville, IN 47130-3084 | 2019-01-23 |
| 1457875460 | Indiana Department of Child Services | Public Health or Welfare | 302 W Washington St Rm E306, Indianapolis, IN 46204-2738 | 2017-08-01 |
| 1609316215 | Affordable Digital Hearing | Public Health or Welfare | 37 Meadows Shopping Ctr, Terre Haute, IN 47803-2373 | 2017-03-01 |
| 1457702599 | New Dawn Behavioral Health LLC | Public Health or Welfare | 4601 Bayard Park Dr Ste 202, Evansville, IN 47714-0602 | 2016-06-30 |
| 1417318429 | Pillar Technologies, LLC | Public Health or Welfare | 25929 N Shore Dr, Elkhart, IN 46514-6309 | 2016-03-18 |
| 1417312570 | Sharon L Chambers Ins Agy Inc | Public Health or Welfare | 5275 Broadway, Gary, IN 46410-1552 | 2015-12-16 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46802 |
Please comment or provide details below to improve the information on SUPER SHOT.
| 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.