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PROFESSIONAL EMERGENCY PHYSICIANS PC NPI 1144215096


NPI Information

NPI: 1144215096
Provider Name: PROFESSIONAL EMERGENCY PHYSICIANS PC

Former Legal Business Name: PROFESSIONAL EMERGENCY PHYSICIANS INC

Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
2200 RANDALLIA DRIVE
FORT WAYNE, IN
ZIP 46805
Phone: (260) 373-4000
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PROFESSIONAL EMERGENCY PHYSICIANS PC is an emergency medicine in Fort Wayne, IN. 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. PROFESSIONAL EMERGENCY PHYSICIANS PC NPI is 1144215096. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Professional Emergency Physicians Inc.

The provider's business location address is:

2200 RANDALLIA DRIVE
FORT WAYNE, IN
ZIP 46805-638
Phone: (260) 373-4000
Fax: (260) 482-4442

The provider's authorized official is Thomas E Gutwein .
The authorized official title is President and has the following contact phone number (260) 482-4440.

The enumeration date for this NPI number is 9/16/2005 and was last updated on 7/22/2019.


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
1363A00000XPhysician AssistantNo
2207P00000XEmergency MedicineYes

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
1100050250 JMEDICAIDINDIANA
2047840OTHERINDIANAMEDICARE CMS
3100050250DMEDICAIDINDIANA
4100050250EMEDICAIDINDIANA
5100050250FMEDICAIDINDIANA
60882335MEDICAIDOHIO
7100050250CMEDICAIDINDIANA
8000000101129OTHERINDIANAANTHEM
9100050250 HMEDICAIDINDIANA
10100050250 IMEDICAIDINDIANA
11100050250AMEDICAIDINDIANA

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.