IndividualActive
Evan Jurjevic
NPI 1154990893 · Sports Physical Therapist · Fort Wayne, IN
Provider details
- NPI number
- 1154990893
- Entity type
- Individual
- Primary specialty
- Sports Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 05014201A (IN)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3946 Ice Way
Fort Wayne, IN 46805-1018
Phone: (260) 266-4007
Street-level locationGet directions
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Registry dates
- Enumerated
- 2021-06-17
- Last updated
- 2021-06-30
- Certified
- 2021-06-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.