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Protailored Physical Therapy LLC

Orthopedic Physical Therapist in Fort Wayne, IN · enumerated 2015 · authorized official Jonathan Evans, Physical Therapist/Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063805042

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Registry record

Entity type Organization (Type 2)
Legal business name Protailored Physical Therapy LLC
Practice address 12722 Tonkel Rd Ste 102, Fort Wayne, IN, 46845
Phone (260) 739-0300
Fax (260) 818-2299
Enumeration date Mar 14, 2015
Last updated in NPPES Jun 1, 2020

Taxonomy & classification

2251X0800X Orthopedic Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 05011654A (IN) Primary

Authorized official

Name Jonathan Evans
Title Physical Therapist/Owner
Phone (260) 570-8239

Other identifiers

Identifier Type State Issuer
201289250A Medicaid IN -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Protailored Physical Therapy LLC?
The NPI for Protailored Physical Therapy LLC is 1063805042, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Protailored Physical Therapy LLC?
NPPES lists Jonathan Evans (Physical Therapist/Owner) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-06-01.