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FORT WAYNE ORTHOPEDICS LLC NPI 1811202963


NPI Information

NPI: 1811202963
Provider Name: FORT WAYNE ORTHOPEDICS, LLC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
3816 NEW VISION DR
FORT WAYNE, IN
ZIP 46845
Phone: (260) 436-8686
Get Directions

FORT WAYNE ORTHOPEDICS, 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 ORTHOPEDICS, LLC NPI is 1811202963. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3816 NEW VISION DR
FORT WAYNE, IN
ZIP 46845-708
Phone: (260) 436-8686
Fax: (260) 459-0036

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

The enumeration date for this NPI number is 8/13/2010 and was last updated on 11/27/2013.


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
6213ES0131XPodiatristFoot Surgery50002482INDIANANo
7363A00000XPhysician Assistant50002482INDIANANo
8207X00000XOrthopaedic Surgery50002482INDIANAYes

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
1100210470MEDICAIDINDIANA
2132560MEDICARE PININDIANA
30162610007OTHERINDIANADME PTAN

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.