FORT WAYNE ORTHOPAEDICS LLC NPI 1255750352

NPI Information

NPI: 1255750352
Provider Name: FORT WAYNE ORTHOPAEDICS, LLC

Doing Business As: FORT WAYNE ORTHOPEDICS, LLC

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

Address:
800 BROADWAY
STE 215
FORT WAYNE, IN
ZIP 46802
Phone: (260) 436-8686
Get Directions

FORT WAYNE ORTHOPAEDICS, LLC is a durable medical equipment medical supplies in Fort Wayne, IN. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. FORT WAYNE ORTHOPAEDICS, LLC NPI is 1255750352. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Fort Wayne Orthopedics, Llc.

The provider's business location address is:

800 BROADWAY
STE 215
FORT WAYNE, IN
ZIP 46802-149
Phone: (260) 436-8686
Fax: (260) 436-8585

The provider's authorized official is Jerald L. Cooper .
The authorized official title is President and has the following contact phone number (260) 436-8686.

The CLIA number assigned to this NPI record is 15D0889456 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/16/2014 and was last updated on 1/27/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207X00000X	Orthopaedic Surgery		50002482	INDIANA	No
2	207XS0106X	Orthopaedic Surgery	Hand Surgery	50002482	INDIANA	No
3	207XS0114X	Orthopaedic Surgery	Adult Reconstructive Orthopaedic Surgery	50002482	INDIANA	No
4	207XS0117X	Orthopaedic Surgery	Orthopaedic Surgery of the Spine	50002482	INDIANA	No
5	207XX0004X	Orthopaedic Surgery	Foot and Ankle Surgery	50002482	INDIANA	No
6	207XX0005X	Orthopaedic Surgery	Sports Medicine	50002482	INDIANA	No
7	207XX0801X	Orthopaedic Surgery	Orthopaedic Trauma	50002482	INDIANA	No
8	213E00000X	Podiatrist		50002482	INDIANA	No
9	213ES0103X	Podiatrist	Foot & Ankle Surgery	50002482	INDIANA	No
10	213ES0131X	Podiatrist	Foot Surgery	50002482	INDIANA	No
11	363A00000X	Physician Assistant		50002482	INDIANA	No
12	363LA2200X	Nurse Practitioner	Adult Health	50002482	INDIANA	No
13	363LF0000X	Nurse Practitioner	Family	50002482	INDIANA	No
14	332B00000X	Durable Medical Equipment & Medical Supplies		50002482	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0162610002	MEDICARE NSC	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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