EAR CLINIC OF INDIANA LLC (NPI# 1497055099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497055099 |
| Entity Type | Organization |
| Organization Name | EAR CLINIC OF INDIANA LLC |
| Practice Address |
9604 Coldwater Rd Ste 101 Fort Wayne IN 46825-2096 |
| Practice Telephone | 2603875820 |
| Mailing Telephone | 2603875820 |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. MICHAEL J DISHER (OWNER) |
| Authorized Official Telephone | 2604144882 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 01044624 | IN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201005050 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6301 University Commons Ste 360, South Bend, IN 466353500 | 2603875820 | 8558287823 |
| Street Address |
9604 COLDWATER RD STE 101 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-2096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205828985 | Michael J Disher | Otolaryngology | 9604 Coldwater Rd Ste 101, Fort Wayne, IN 46825-2096 | 2005-08-18 |
| 1780215525 | Brittany Elise Serovy | Nurse Practitioner | 9604 Coldwater Rd Ste 101, Fort Wayne, IN 46825-2096 | 2020-01-30 |
| 1750933560 | Danielle Marie Castillo | Registered Nurse | 9604 Coldwater Rd Ste 101, Fort Wayne, IN 46825-2096 | 2019-07-11 |
| 1760594550 | Deborah E. King | Audiologist | 9604 Coldwater Rd Ste 101, Fort Wayne, IN 46825-2096 | 2006-08-31 |
| 1194701300 | Denise A Bickley | Audiologist | 9604 Coldwater Rd Ste 101, Fort Wayne, IN 46825-2096 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679078398 | Wright Choice Hairquarters | Specialist | 1815 Fox Point Trl Apt 2, Fort Wayne, IN 46816-2450 | 2018-03-26 |
| 1225581945 | Hossam Eldine Kamal Youssef | Specialist | 7230 Engle Rd Ste 303, Fort Wayne, IN 46804-2227 | 2016-07-28 |
| 1245600972 | Pediatric Cardiology Associates | Specialist | 5107 N Bend Dr, Fort Wayne, IN 46804-1753 | 2015-10-07 |
| 1598168197 | Melinda Elise Smith | Specialist | 5812 Maplecrest Rd, Fort Wayne, IN 46835-3840 | 2014-09-27 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1790076453 | Susan Anne Walstra | Specialist | 4601 Heatherwind Dr, Apt. D, Fort Wayne, IN 46815-7135 | 2011-04-28 |
| 1265755250 | William A Argus Md PC | Specialist | 7030 Pointe Inverness Way Ste 240, Fort Wayne, IN 46804-7925 | 2010-03-05 |
| 1033376413 | A Step Ahead Therapies, LLC | Specialist | 6013 Belle Isle Ln, Fort Wayne, IN 46835-1263 | 2008-05-21 |
| 1932370590 | Kerri Jo Trentacosti | Specialist | 5939 Brighton Meadows Dr, Apt. C, Fort Wayne, IN 46804-7664 | 2008-03-21 |
| 1649458662 | Bernice Wilson | Specialist | 4202 Buell Dr, Fort Wayne, IN 46807-2743 | 2008-01-31 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on EAR CLINIC OF INDIANA LLC.
| 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.