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FORT WAYNE ORTHOPAEDICS LLC NPI 1497758429


NPI Information

NPI: 1497758429
Provider Name: FORT WAYNE ORTHOPAEDICS LLC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
7601 W JEFFERSON BLVD
FORT WAYNE, IN
ZIP 46804
Phone: (260) 436-8686
Get Directions

FORT WAYNE ORTHOPAEDICS LLC is an orthopaedic surgery in Fort Wayne, IN. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. FORT WAYNE ORTHOPAEDICS LLC NPI is 1497758429. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7601 W JEFFERSON BLVD
FORT WAYNE, IN
ZIP 46804-133
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 enumeration date for this NPI number is 5/23/2005 and was last updated on 11/19/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XS0106XOrthopaedic SurgeryHand Surgery50002482INDIANANo
2207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine50002482INDIANANo
3207XX0005XOrthopaedic SurgerySports Medicine50002482INDIANANo
4207XX0801XOrthopaedic SurgeryOrthopaedic Trauma50002482INDIANANo
5213E00000XPodiatrist50002482INDIANANo
6213ES0103XPodiatristFoot & Ankle SurgeryNo
7363A00000XPhysician Assistant50002482AINDIANANo
8363L00000XNurse Practitioner50002482AINDIANANo
9363LF0000XNurse PractitionerFamilyNo
10207X00000XOrthopaedic Surgery50002482AINDIANAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1132560MEDICARE PININDIANA
2201255250MEDICAIDINDIANA
3H095990MEDICARE PINOHIO
4665600MEDICARE PININDIANA
50162610001MEDICARE NSCINDIANA
6MI3528MEDICARE PINMICHIGAN
7452290MEDICARE PININDIANA

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

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