=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316874522
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDIANA WESLEYAN UNIVERSITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1310 MANCHESTER AVE
-----------------------------------------------------
City | WABASH
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46992-1615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 260-563-5630
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4411 S ADAMS ST
-----------------------------------------------------
City | MARION
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46953-5349
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-674-4455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | JEFF RAYIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 765-677-6573
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------