OrganizationActive
Fort Wayne Medical Education Program
NPI 1184635153 · Family Medicine Physician · Fort Wayne, IN
Provider details
- NPI number
- 1184635153
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kimberly Harris, Chief Operating Officer(260) 423-2682
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
750 Broadway
Suite 350
Fort Wayne, IN 46802-1412
Phone: (260) 423-2675
Fax: (260) 423-6621
Street-level locationGet directions
Mailing address
750 Broadway
Fort Wayne, IN 46802-1412
Other names (DBA / former)
- Doing business as
- The Family Medicine Center
Registry dates
- Enumerated
- 2006-08-11
- Last updated
- 2015-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.