PATRICK ANDREW MACKNICK (NPI# 1861647000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861647000 |
Entity Type | Individual |
Full Name | PATRICK ANDREW MACKNICK |
Credential | PA-C |
Practice Address |
1818 Carew St Suite 250 Fort Wayne IN 46805-4788 |
Mailing Address |
1234 E Dupont Rd Suite 3 Fort Wayne IN 46825-1545 |
Practice Telephone | 2604836448 |
Mailing Telephone | 2603739965 |
Enumeration Date | 2008-12-01 |
Last Update Date | 2009-11-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | PENDING | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | ANTHEM | 000000614685 | 01 |
IN | MEDICARE RR | P00755205 | 01 |
Street Address |
1818 CAREW ST SUITE 250 |
City | FORT WAYNE |
State | IN |
Zip Code | 46805-4788 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447257795 | P. Rao Gummadi | Anesthesiology | 1818 Carew St, Suite 220, Fort Wayne, IN 46805-4788 | 2005-07-01 |
1912393570 | Kelly Horn | Midwife | 1818 Carew St, Suite 300, Fort Wayne, IN 46805-4788 | 2015-04-10 |
1295141380 | Gynecologic Oncology of Northeast Indiana, LLC | Obstetrics & Gynecology | 1818 Carew St, Suite 250, Fort Wayne, IN 46805-4788 | 2014-07-09 |
1174802649 | Matthew L Runyan | Psychiatry & Neurology | 1818 Carew St, Suite 230, Fort Wayne, IN 46805-4788 | 2011-08-15 |
1013169275 | Jeri Ann Forrest | Social Worker | 1818 Carew St, Suite 230, Fort Wayne, IN 46805-4788 | 2008-10-21 |
1013179357 | Carol Pai Wain Garrean | Internal Medicine | 1818 Carew St, Suite 260, Fort Wayne, IN 46805-4788 | 2008-06-27 |
1922156512 | Robert W Miner | Psychiatry & Neurology | 1818 Carew St, Fort Wayne, IN 46805-4788 | 2007-01-08 |
1316011349 | Parkview Health System, Inc. | Durable Medical Equipment & Medical Supplies | 1818 Carew St, Suite 260, Fort Wayne, IN 46805-4792 | 2006-11-20 |
1801960596 | Parkview Health System, Inc. | Durable Medical Equipment & Medical Supplies | 1818 Carew St, Suite 240, Fort Wayne, IN 46805-4788 | 2006-11-17 |
1508945809 | Fort Wayne Urology Inc. | Urology | 1818 Carew St, Suite 210, Fort Wayne, IN 46805-4788 | 2006-11-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
Find all providers in zip 46805 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104438944 | Erin R Griffin | Physician Assistant | 5621 Woodshire Dr Apt 5, Fort Wayne, IN 46835-2959 | 2020-08-22 |
1821608209 | Rebecca Coker | Physician Assistant | 5137 Truemper Way Apt 5, Fort Wayne, IN 46835-3252 | 2020-07-31 |
1114536844 | Amanda Kohl | Physician Assistant | 5429 River Run Trl # 5, Fort Wayne, IN 46825-6039 | 2020-07-29 |
1538778352 | Kiersten Michelle Coatney | Physician Assistant | 3924 Taylor Rd Apt 65, Fort Wayne, IN 46804-1945 | 2020-07-28 |
1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
1972890093 | Megan Bearman | Physician Assistant | 3640 New Vision Dr, Suite A, Fort Wayne, IN 46845-1717 | 2011-07-10 |
1114211729 | Joel A Ruetz | Physician Assistant | 7619 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2011-06-01 |
1568617256 | Parkview Health System Inc | Physician Assistant | 11104 Parkview Circle Dr Ste 320, Fort Wayne, IN 46845-1733 | 2008-11-21 |
1841441805 | Brooke B Kutka | Physician Assistant | 2512 East Dupont Rd, Suite 200, Fort Wayne, IN 46825-1609 | 2008-10-08 |
1265688808 | Kali E Veness | Physician Assistant | 2930 Lake Ave, Fort Wayne, IN 46805-5416 | 2008-08-14 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46805 |
Please comment or provide details below to improve the information on PATRICK ANDREW MACKNICK.
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.