| Qhg Of Fort Wayne Company Llc | |
|
7333 W Jefferson Blvd Fort Wayne IN 46804-6280 | |
| (260) 458-3843 | |
| (260) 637-1601 |
| Full Name | Qhg Of Fort Wayne Company Llc |
|---|---|
| Speciality | General Practice |
| Location | 7333 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Kristina Music (DIRECTOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Qhg Of Fort Wayne Company Llc Po Box 689022 Franklin TN 37068-9022 Ph: () - | Qhg Of Fort Wayne Company Llc 7333 W Jefferson Blvd Fort Wayne IN 46804-6280 Ph: (260) 458-3843 |
| NPI Number | 1619918026 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 8628988367 |
|---|---|
| Medicare Enrollment ID | O20040429000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619918026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| Provider Name | Delynn H Elzey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407894611 PECOS PAC ID: 2961678529 Enrollment ID: I20120103000225 |
| Provider Name | Steven E Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982648895 PECOS PAC ID: 2668648221 Enrollment ID: I20120103000248 |
| Provider Name | Andrea D Beard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891049086 PECOS PAC ID: 8426290453 Enrollment ID: I20130805000147 |
| Provider Name | Susan M Maloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811276751 PECOS PAC ID: 9335461938 Enrollment ID: I20141210001633 |
| Provider Name | Kimberly A. Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245850106 PECOS PAC ID: 5799106449 Enrollment ID: I20200604000762 |
| Provider Name | Melissa Sue Parnin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134730427 PECOS PAC ID: 0345638805 Enrollment ID: I20221122000508 |
| Provider Name | Angie Stinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770383689 PECOS PAC ID: 2062936628 Enrollment ID: I20250404002427 |
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