DR. PATRICE C ELLINGSON (NPI# 1639163884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639163884 |
| Entity Type | Individual |
| Full Name | DR. PATRICE C ELLINGSON |
| Credential | O.D. |
| Practice Address |
1515 E Paulding Rd Fort Wayne IN 46816 |
| Mailing Address |
1515 E Paulding Rd Fort Wayne IN 46816-1252 |
| Practice Telephone | 2607442273 |
| Practice Fax Number | 2607444555 |
| Mailing Telephone | 2607442273 |
| Mailing Fax Number | 2607444555 |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2018-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 18002448 | IN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100411890A | 05 | |
| IN | MEDICARE RR | 410040819 | 01 |
| IN | ANTHEM NONPAR | 000000243494 | 01 |
| IN | MEDICARE RR | 410017027 | 01 |
| IN | 100411890 | 05 |
| Street Address |
1515 E PAULDING RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477547628 | Bradley S Basham | Optometrist | 1515 E Paulding Rd, Fort Wayne, IN 46816-1252 | 2005-09-02 |
| 1396778882 | Fort Wayne Family Eyecare | Optometrist | 1515 E Paulding Rd, Fort Wayne, IN 46816-1252 | 2006-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841769270 | Brian Bernard Conaway | Occupational Therapist | 7125 S Hanna St, Fort Wayne, IN 46816 | 2018-11-14 |
| 1073006938 | Fort Wayne Aal Lp | Assisted Living Facility | 7125 S Hanna Street, Fort Wayne, IN 46816 | 2018-06-14 |
| 1811282064 | Connisha Sanders | Occupational Therapy Assistant | 8309, Bridgeway Cir Apt 3a, Fort Wayne, IN 46816 | 2011-06-16 |
| 1144239609 | James J Bohlin | Dentist | 7524 South Anthony Blvd., Fort Wayne, IN 46816 | 2006-08-05 |
| 1578594537 | K Mart Corp | Pharmacy | 7530 S Anthony Blvd, Fort Wayne, IN 46816 | 2006-07-06 |
| 1720540503 | Jill Ann Woodward | Occupational Therapy Assistant | 7125 S Hanna St, Fort Wayne, IN 46816 | 2019-04-02 |
| 1114140134 | Jon D. Ingleman | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1016 | 2007-04-10 |
| 1538189063 | Yoder/rahrig Family Dentistry | Dentist | 333 E Tillman Rd, Fort Wayne, IN 46816-1017 | 2006-07-20 |
| 1619997137 | Gerald J. Rahrig | Dentist | 333 E Tillman Rd, Fort Wayne, IN 46816-1017 | 2006-07-20 |
| 1780235374 | Kathryn Welch | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1079 | 2019-09-25 |
| Find all providers in zip 46816 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164046967 | Dr Bennett LLC | Optometrist | 1850 E Dupont Rd, Fort Wayne, IN 46825-1581 | 2020-06-08 |
| 1043737737 | Eyecare Express | Optometrist | 4826 Illinois Rd, Fort Wayne, IN 46804-1166 | 2017-08-24 |
| 1760906135 | Brittany Hoolsema | Optometrist | 2121 Lake Ave # 112b, Fort Wayne, IN 46805-5100 | 2017-07-27 |
| 1801326533 | Kimberly M Kindt | Optometrist | 9426 Lima Rd Ste C, Fort Wayne, IN 46818 | 2017-06-15 |
| 1083003008 | Midwest Eye Consultants, P.C. | Optometrist | 1601 E Paulding Rd, Fort Wayne, IN 46816-1204 | 2015-01-14 |
| 1437494143 | Fort Wayne Vision Associates Ltd | Optometrist | 515 E Coliseum Blvd, Fort Wayne, IN 46805-1215 | 2012-12-06 |
| 1033453220 | Daniel & Max | Optometrist | 409 E Coliseum Blvd, Fort Wayne, IN 46805-1004 | 2012-11-12 |
| 1205114006 | Ryan Feichtner | Optometrist | 700 E Coliseum Blvd, Fort Wayne, IN 46805-1220 | 2011-07-27 |
| 1760786503 | C J Pataluch Od PC | Optometrist | 5659 Coventry Ln, Fort Wayne, IN 46804-7145 | 2011-01-10 |
| 1841436532 | James H Pennington Od | Optometrist | 6421 Georgetown North Blvd, Fort Wayne, IN 46815-7007 | 2008-12-30 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46816 |
Please comment or provide details below to improve the information on DR. PATRICE C ELLINGSON.
| 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.