PEDIATRIC NURSING SPECIALISTS OF INDIANA, INC. (NPI# 1992796619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992796619 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC NURSING SPECIALISTS OF INDIANA, INC. |
| Other Organization Name | DEACONESS HOMECARE |
| Practice Address |
6523 Constitution Dr Fort Wayne IN 46804-1551 |
| Mailing Address |
Po Box 16809 Hattiesburg MS 39404-6809 |
| Practice Telephone | 2604329699 |
| Practice Fax Number | 2604325617 |
| Mailing Telephone | 6012681842 |
| Mailing Fax Number | 6012687898 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS NANCY C JAKUS (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Telephone | 6012681842 |
| Authorized Official Credential | RN BSN MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Other Name | Type Code |
|---|---|
| Deaconess HomeCare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700877354 | Pediatric Nursing Specialists of Indiana, Inc. | Home Health | 3500 Depauw Blvd, Suite 1041, Indianapolis, IN 46268-1170 | 2005-11-02 |
| 1316938152 | Pediatric Nursing Specialists of Indiana, Inc. | Home Health | 3207 Cascade Dr, Valparaiso, IN 46383-9149 | 2005-11-01 |
| Street Address |
6523 CONSTITUTION DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-1551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194352195 | Ceara D Freeman | Home Health | 1044 Tennessee Ave, Fort Wayne, IN 46805-4265 | 2020-03-27 |
| 1346871712 | Sterling Home Health Care, Inc. | Home Health | 7231 W Jefferson Blvd, Fort Wayne, IN 46804-6279 | 2020-02-04 |
| 1558837765 | Shirley A Malone | Home Health | 3488 Stellhorn Rd Unit B, Fort Wayne, IN 46815-4630 | 2018-10-16 |
| 1336640721 | Apple Tree Home Health Care Services, LLC | Home Health | 4409 Winston Dr, Fort Wayne, IN 46806-2535 | 2018-02-22 |
| 1013430180 | League for The Blind and Disabled, Inc | Home Health | 5821 S Anthony Blvd, Fort Wayne, IN 46816-3701 | 2017-07-20 |
| 1740729383 | Bayada Home Health Care, Inc. | Home Health | 6351 Constitution Dr, Fort Wayne, IN 46804-1547 | 2017-02-15 |
| 1124566138 | Together Homecare of Fort Wayne LLC | Home Health | 5614 Industrial Rd, Fort Wayne, IN 46825-5126 | 2017-02-09 |
| 1588909808 | Am Home Health Care, LLP | Home Health | 2021 Chartwell Dr, Fort Wayne, IN 46816-1384 | 2012-11-28 |
| 1508125345 | Advantage Infusion Group, LLC | Home Health | 503 Airport North Office Park, Fort Wayne, IN 46825-6705 | 2012-05-14 |
| 1851658223 | At Home Health Care Agency, LLC | Home Health | 3001 Fairfield Ave, Fort Wayne, IN 46807-1600 | 2012-04-23 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on PEDIATRIC NURSING SPECIALISTS OF INDIANA, INC..
| 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.