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NORTHEAST OBSTETRICS & GYNECOLOGY LLC NPI 1811941024


NPI Information

NPI: 1811941024
Provider Name: NORTHEAST OBSTETRICS & GYNECOLOGY, LLC

Doing Business As: NORTHEAST OB-GYN, LLC

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
11123 PARKVIEW PLAZA DR
SUITE 101
FORT WAYNE, IN
ZIP 46845
Phone: (260) 422-7455
Get Directions

NORTHEAST OBSTETRICS & GYNECOLOGY, LLC is a medical specialty clinic center in Fort Wayne, IN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). NORTHEAST OBSTETRICS & GYNECOLOGY, LLC NPI is 1811941024. The provider is registered as an organization entity type.
The provider Is Doing Business As Northeast Ob-gyn, Llc.

The provider's business location address is:

11123 PARKVIEW PLAZA DR
SUITE 101
FORT WAYNE, IN
ZIP 46845-707
Phone: (260) 422-7455
Fax: (260) 424-9356

The provider's authorized official is Tamara A Furniss .
The authorized official title is Business Manager and has the following contact phone number (260) 426-7755.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 6/24/2008.


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
1261QM2500XClinic/CenterMedical Specialty50001834AINDIANAYes

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
1100055270AMEDICAIDINDIANA
2219880MEDICARE 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: 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.