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PROTAILORED PHYSICAL THERAPY LLC
NPI 1063805042
Physical Therapist - Orthopedic in Fort Wayne, IN

Active since March 14, 2015
12722 TONKEL RD STE 102, FORT WAYNE, IN 46845(260) 739-0300(260) 818-2299 Get Directions Write a Review

NPPES record last updated: June 1, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Protailored Physical Therapy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROTAILORED PHYSICAL THERAPY LLC (NPI 1063805042) is a healthcare organization registered as an orthopedic in Fort Wayne, Indiana and active in the NPI registry since March 2015. The organization lists Jonathan T Evans, Physical Therapist/owner, as its authorized official.

NPPES Registry Identity

NPI1063805042
Entity TypeOrganization
Primary Taxonomy2251X0800X
Legal Business NamePROTAILORED PHYSICAL THERAPY LLC
Location Address12722 TONKEL RD STE 102Fort Wayne, IN 46845-8201
Mailing Address12722 Tonkel Rd Ste 102Fort Wayne, IN 46845-8201 · (260) 739-0300 · Fax (260) 818-2299
Phone(260) 739-0300
Fax(260) 818-2299
Organization SubpartNo
Authorized OfficialJonathan T EvansPhysical Therapist/owner · (260) 570-8239
Enumeration DateMarch 14, 2015
Last NPPES UpdateJune 1, 2020
NPPES CertifiedJune 1, 2020
✔ NPI 1063805042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License✔ Licensed in IN · 05011654A
Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

12722 TONKEL RD STE 102, Fort Wayne, IN 46845
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Other Identifiers 1

Medicaid201289250AIN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONATHAN EVANS DPT
Physical Therapist (Orthopedic)
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300
KATLIN R COUCHMAN OTD
Occupational Therapist
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300
KELSEY M NEUMAN DPT
Physical Therapist
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300
NICHOLAS ALLEN OT
Occupational Therapist
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300
GRACIE CLICKOVICH DPT
Physical Therapist
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300
CHELSEA R JONES DPT
Physical Therapist
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300
ZACHARY SCHMUCKER DPT
Physical Therapist (Orthopedic)
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300
CALEB S GABLER DPT
Physical Therapist
12722 TONKEL RD STE 102
FORT WAYNE, IN 46845
Allen County (260) 739-0300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Protailored Physical Therapy LLC's NPI number?

The NPI number for Protailored Physical Therapy LLC is 1063805042. It was assigned to this organization in the NPPES registry on March 14, 2015.

Where is Protailored Physical Therapy LLC located?

Protailored Physical Therapy LLC is located at 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845. The listed phone number is (260) 739-0300.

What is Protailored Physical Therapy LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

What insurance does Protailored Physical Therapy LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Protailored Physical Therapy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Protailored Physical Therapy LLC was last updated on June 1, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.