INNOVATIVE PROFESSIONAL SERVICE LLC (NPI# 1679836910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679836910 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE PROFESSIONAL SERVICE LLC |
| Practice Address |
3464 Stellhorn Rd Fort Wayne IN 46815-4630 |
| Practice Telephone | 2604326508 |
| Practice Fax Number | 2604326586 |
| Mailing Telephone | 2604326508 |
| Mailing Fax Number | 2604326586 |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-06-21 |
| Authorized Official Name | MR. TERRY YEITER (OFFICE MANAGER) |
| Authorized Official Telephone | 2604326508 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 01025672 | IN | Allopathic & Osteopathic Physicians |
| Street Address |
3464 STELLHORN RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-4630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215411020 | Stellhorn Wellness, LLC | Family Medicine | 3464 Stellhorn Rd, Fort Wayne, IN 46815-4630 | 2018-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1871074732 | Healthy Schools Indiana LLC | General Practice | 6605 E State Blvd Ste 9, Fort Wayne, IN 46815-7036 | 2018-08-28 |
| 1801138102 | Family Health Practitioners, LLC | General Practice | 909 River Oak Run, Fort Wayne, IN 46804-3543 | 2013-03-25 |
| 1003134123 | Aptcare In 1 | General Practice | 11718 Woodstream Ridge Ct, Fort Wayne, IN 46845-1908 | 2010-05-13 |
| 1104395680 | Regen Med of Indiana LLC | General Practice | 5931 Stoney Creek Dr, Fort Wayne, IN 46825-4401 | 2018-11-14 |
| 1750743381 | Aptcare LLC | General Practice | 11718 Woodstream Ridge Ct, Fort Wayne, IN 46845-1908 | 2016-03-23 |
| 1619044047 | Robert L Arnold Dds Inc | General Practice | 5800 Fairfield Ave, Suite 220, Fort Wayne, IN 46807-3437 | 2006-11-29 |
| 1083726848 | Robert L Arnold | General Practice | 5800 Fairfield Ave, Suite 220, Fort Wayne, IN 46807-3437 | 2006-08-31 |
| 1518909985 | Qhg of Fort Wayne Company LLC | General Practice | 7333 W Jefferson Blvd, Fort Wayne, IN 46804-6280 | 2006-06-12 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on INNOVATIVE PROFESSIONAL SERVICE 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.