FORT WAYNE ORTHOPEDICS, LLC (NPI# 1043525009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043525009 |
Entity Type | Organization |
Organization Name | FORT WAYNE ORTHOPEDICS, LLC |
Practice Address |
315 W Old Key Dr Suite 140 Peru IN 46970-9058 |
Mailing Address |
Po Box 2526 Fort Wayne IN 46801-2526 |
Practice Telephone | 2604368686 |
Practice Fax Number | 2604590036 |
Mailing Telephone | 2604368686 |
Mailing Fax Number | 2604325075 |
Enumeration Date | 2010-08-16 |
Last Update Date | 2013-11-27 |
Authorized Official Name | JERALD L. COOPER (M.D./PRESIDENT) |
Authorized Official Telephone | 2604368686 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
50002482 | IN | Allopathic & Osteopathic Physicians |
N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
50002482 | IN | Allopathic & Osteopathic Physicians |
N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
50002482 | IN | Allopathic & Osteopathic Physicians |
N | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
50002482 | IN | Allopathic & Osteopathic Physicians |
N | 213E00000X | Podiatrist | 50002482 | IN | Podiatric Medicine & Surgery Service Providers |
N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
50002482 | IN | Podiatric Medicine & Surgery Service Providers |
N | 363A00000X | Physician Assistant | 50002482 | IN | Physician Assistants & Advanced Practice Nursing Providers |
Y | 207X00000X | Orthopaedic Surgery | 50002482 | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 100210470 | 05 | |
IN | DME PTAN | 0162610011 | 01 |
IN | 100210470A | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881909935 | Fort Wayne Orthopedics, LLC | Orthopaedic Surgery | 207 N Townline Rd, Lagrange, IN 46761-1325 | 2010-08-13 |
1518272665 | Fort Wayne Orthopedics, LLC | Orthopaedic Surgery | 816 Main St, Rochester, IN 46975-1543 | 2010-08-13 |
1811202963 | Fort Wayne Orthopedics, LLC | Orthopaedic Surgery | 3816 New Vision Dr, Fort Wayne, IN 46845-1708 | 2010-08-13 |
1184939233 | Fort Wayne Orthopedics, LLC | Orthopaedic Surgery | 315 Lehman Ave, Topeka, IN 46571-9476 | 2010-08-13 |
Street Address |
315 W OLD KEY DR SUITE 140 |
City | PERU |
State | IN |
Zip Code | 46970-9058 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689602062 | William Charles Hoover | Family Medicine | 315 W Old Key Dr, Peru, IN 46970-9057 | 2006-06-28 |
1346621000 | Lisa Ann Jones | Nurse Practitioner | 315 W Old Key Dr, Peru, IN 46970-9057 | 2015-06-17 |
1780988428 | Elizabeth A. Jernagan | Nurse Practitioner | 315 W Old Key Dr, Peru, IN 46970-9057 | 2011-01-10 |
1558661744 | Doris M Carden | Nurse Practitioner | 315 W Old Key Dr, Peru, IN 46970-9057 | 2010-10-22 |
1003140419 | Alliance Healthcare Services Inc | Clinic/Center | 315 W Old Key Dr, Peru, IN 46970-9057 | 2009-10-01 |
1629247028 | Cancer Care Group, P.C. | Radiology | 315 W Old Key Dr, Suite 140, Peru, IN 46970-9057 | 2008-02-29 |
1730266602 | Lavonne Eddy | Nurse Practitioner | 315 W Old Key Dr, Peru, IN 46970-9057 | 2006-10-31 |
1255418125 | Lloyd Lorenz | Family Medicine | 315 W Old Key Dr, Peru, IN 46970-9057 | 2006-10-31 |
1134206014 | Michael Mull | Family Medicine | 315 W Old Key Dr, Peru, IN 46970-9057 | 2006-10-31 |
1013094994 | Heather Weber | Nurse Practitioner | 315 W Old Key Dr, Peru, IN 46970-9057 | 2006-10-31 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447896311 | Christina M Van Meter | Pharmacist | 930 W Main St., Peru, IN 46970 | 2019-11-26 |
1821554585 | Thomas Gilbert Reaves | Counselor | 5851 S. Us-31, Lot 47, Peru, IN 46970 | 2019-02-18 |
1104154863 | American Foot and Ankle Inc | Durable Medical Equipment & Medical Supplies | 632 West Main Street, Peru, IN 46970 | 2009-11-18 |
1629208251 | Rafik Farag | Family Medicine | 1694 W Logansport Rd., Community Health Center of Miami County, Peru, IN 46970 | 2009-07-16 |
1508076050 | Peggy L Wert | Occupational Therapy Assistant | 850 Matador Drive, Peru, IN 46970 | 2007-05-23 |
1972690634 | Sherif Elmasry | Pediatrics | 655 N Broadway, Peru, IN 46970 | 2006-10-06 |
1548357320 | Belinda Diane Stonger | Hearing Instrument Specialist | 1 S. Broadway, Peru, IN 46970 | 2006-10-05 |
1134214083 | American Health Network of Indiana, LLC | Durable Medical Equipment & Medical Supplies | 315 West Old Key Drive, Peru, IN 46970 | 2006-10-04 |
1710082409 | Thomas J Guthrie | Dentist | 5 West Logan Street, Peru, IN 46970 | 2006-09-14 |
1750921938 | Christina Russell | Counselor | 1000 N Broadway Ste A, Peru, IN 46970 | 2020-01-15 |
Find all providers in zip 46970 |
Taxonomy Code | 207X00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
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. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851631592 | Connor Kasik | Orthopaedic Surgery | 920 West St Ste 211, Peru, IL 61354-2769 | 2013-02-17 |
1013986926 | Gregory A Konrath | Orthopaedic Surgery | 285 W 12th St, Ste 106, Peru, IN 46970-1653 | 2006-03-14 |
1922114040 | Jason Allan Bergandi | Orthopaedic Surgery | 4231 Progress Blvd, 4, Peru, IL 61354-1193 | 2006-08-22 |
1043250459 | Peter J Meier | Orthopaedic Surgery | 920 West St, Ste 211, Peru, IL 61354-2763 | 2006-06-07 |
1467491092 | Robert J Mitchell | Orthopaedic Surgery | 920 West St, Ste 211, Peru, IL 61354-2763 | 2006-06-06 |
1710935325 | Charles R Kershner | Orthopaedic Surgery | 285 W 12th St, 106, Peru, IN 46970-1653 | 2006-05-05 |
1073578662 | William Pohnert | Orthopaedic Surgery | 285 W 12th St, Ste. 106, Peru, IN 46970-1653 | 2006-04-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164038618 | Union Associated Physicians Clinic, LLC | Orthopaedic Surgery | 801 S Main St Ste 200, Clinton, IN 47842-2261 | 2020-09-21 |
1699317529 | Lakeshore Bone & Joint Institute, PC | Orthopaedic Surgery | 759 45th St Ste 201, Munster, IN 46321-2938 | 2019-10-11 |
1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
1104330034 | Hinsdale Orthopaedic Associates, S.c. | Orthopaedic Surgery | 8141 S Calumet Ave, Unit 1, Munster, IN 46321 | 2017-11-30 |
1679022925 | Stephen Stein | Orthopaedic Surgery | 13198 N County Road 400 E, Batesville, IN 47006-8881 | 2016-09-28 |
1013371277 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 17471 Wheeler Road, Suite 112, Westfield, IN 46074-6901 | 2016-04-13 |
1194184671 | Greenwood Orthopedics PC | Orthopaedic Surgery | 965 Emerson Parkway, Suite K, Greenwood, IN 46143-6274 | 2016-02-12 |
1467826032 | Franciscan Physician Network | Orthopaedic Surgery | 759 45th Street, Suite 201, Munster, IN 46321 | 2015-11-19 |
1285019851 | Community Physicians of Indiana Inc | Orthopaedic Surgery | 2312 S Dixon Road, Suite 200, Kokomo, IN 46902-6423 | 2015-07-24 |
1730561291 | Cody Shafer | Orthopaedic Surgery | 1120 W Michigan St Rm 600, Indianapolis, IN 46202-5209 | 2015-06-22 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.