CHRISTINA A TATARA (NPI# 1760912026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760912026 |
| Entity Type | Individual |
| Full Name | CHRISTINA A TATARA |
| Credential | DO |
| Practice Address |
6511 E State Blvd Fort Wayne IN 46815-7026 |
| Mailing Address |
6920 Pointe Inverness Way Ste 200 Fort Wayne IN 46804-7934 |
| Practice Telephone | 2604252725 |
| Mailing Telephone | 2604793516 |
| Mailing Fax Number | 2604793520 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2020-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 02005457A | IN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 11019568A | IN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 750 Broadway Ste 350, Fort Wayne, IN 468021412 | 2604232675 | 2604236621 |
| Street Address |
6511 E STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-7026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154956209 | Nathan D. Nicola | Nurse Practitioner | 6511 E State Blvd, Fort Wayne, IN 46815-7026 | 2020-03-10 |
| 1790206977 | Allen Richard Maertin | Family Medicine | 6511 E State Blvd, Fort Wayne, IN 46815-7026 | 2017-06-28 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700317633 | Robert Campbell | Family Medicine | 7411 Hope Dr, Fort Wayne, IN 46815-5687 | 2017-03-22 |
| 1487196424 | American Vein Institute LLC | Family Medicine | 10020 Dupont Circle Ct Ste 140, Fort Wayne, IN 46825-1621 | 2016-11-08 |
| 1831547124 | Anna Menze | Family Medicine | 10307 Dupont Circle Dr W Ste A, Fort Wayne, IN 46825-1633 | 2016-05-27 |
| 1407203672 | Credo Health Group, LLC | Family Medicine | 10228 Dupont Circle Dr E # 100b, Fort Wayne, IN 46825-1611 | 2016-05-18 |
| 1649625104 | Gabrielle Paloma Acquaro | Family Medicine | 7806 W Jefferson Blvd Ste E, Fort Wayne, IN 46804-4180 | 2016-05-03 |
| 1720491731 | John E Marx | Family Medicine | 1007 W Rudisill Blvd, Fort Wayne, IN 46807-2170 | 2014-06-06 |
| 1457763252 | Amy Simpson | Family Medicine | 1818 Carew St Ste 120, Fort Wayne, IN 46805-4764 | 2014-05-28 |
| 1932536083 | Clifford James Shultz | Family Medicine | 2616 Covington Pointe Trl, Fort Wayne, IN 46804-2773 | 2013-10-03 |
| 1164860086 | Andrew J Mullally | Family Medicine | 10050 Auburn Park Dr, Fort Wayne, IN 46825-2389 | 2013-06-13 |
| 1891060075 | Amanda J Patch | Family Medicine | 5693 Ymca Park Dr W, Fort Wayne, IN 46835-3280 | 2012-03-20 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on CHRISTINA A TATARA.
| 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.