MEDICARE: ELAINE BUCHMEIER RD, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	37003995A	IN
2	133VN1004X	Pediatric Nutrition Registered Dietitian	37003995A	IN

General Provider Information

NPI Number	:	1801743497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE BUCHMEIER RD, LD

Provider Business Mailing Address
First Line	:	1716 TRADERS XING
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1536
Country	:	US
Telephone Number	:	260-266-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11123 PARKVIEW PLAZA DR STE 200
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1707
Country	:	US
Telephone Number	:	260-425-6100
Fax Number	:	260-425-6105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	05/20/2026

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