Provider Type Icon

NICHOLAS GOULD DO NPI 1053725655


NPI Information

NPI: 1053725655
Provider Name: NICHOLAS GOULD, DO
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual
Organization: PROFESSIONAL EMERGENCY PHYSICIANS PC

PECOS Registration: Yes

Address:
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN
ZIP 46845
Phone: (260) 266-1000
Get Directions

Nicholas Gould, DO is an emergency medicine in Fort Wayne, IN with 10 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. Nicholas Gould, DO NPI is 1053725655. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: KENTUCKY SCHOOL OF MEDICINE
Graduation Year:2014

The provider's business location address is:

11109 PARKVIEW PLAZA DR
FORT WAYNE, IN
ZIP 46845-701
Phone: (260) 266-1000

The NPI 1053725655 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/12/2014 and was last updated on 3/17/2018.


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
1207P00000XEmergency Medicine02004955AINDIANAYes

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
1201397300MEDICAIDINDIANA
2000001080016OTHERINDIANAANTHEM
3047840077OTHERINDIANAMEDICARE

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: 11/14/2023

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.