PAUL T. STOCKMANN (NPI# 1588664932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588664932 |
| Entity Type | Individual |
| Full Name | PAUL T. STOCKMANN |
| Credential | M.D. |
| Practice Address |
11123 Parkview Plaza Dr Ste 200 Fort Wayne IN 46845-1707 |
| Mailing Address |
Childrens Hospital of Michigan 3901 Beaubien Blvd Detroit MI 48201 |
| Practice Telephone | 2604256100 |
| Practice Fax Number | 2604256105 |
| Mailing Telephone | 3138313220 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
01078636A | IN | Allopathic & Osteopathic Physicians |
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
057466 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CHAMPUS-CHAMPUS | PS057466 | 01 | |
| MI | BLUE CROSS BLUE SHIELD MI | 020H277290 | 01 |
| MI | 329955410 | 05 | |
| COMMERCIAL-COMMERCIAL NUMBER | PS057466 | 01 | |
| BLUE CROSS-BLUE CROSS | 700H262310 | 01 | |
| MI | GROUP NPI | 1396817714 | 01 |
| MI | 3289600 | 05 | |
| MI | 4115660 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 468451707 | 2604256100 | 2604256105 |
| Street Address |
11123 PARKVIEW PLAZA DR STE 200 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275092629 | Alda E. Taube | Registered Nurse | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1707 | 2019-03-15 |
| 1063997146 | Emily Otter | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1707 | 2018-09-25 |
| 1730450305 | Josette C. Klink | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845 | 2012-01-13 |
| 1124250915 | Vimal Jayswal | Pediatrics | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1707 | 2009-08-13 |
| 1528024783 | William A Loe Jr. | Surgery | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528024783 | William A Loe Jr. | Surgery | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845 | 2006-04-25 |
| 1669455267 | Great Lakes Pediatric Surgeons, Inc. | Surgery | 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182 | 2005-11-29 |
| 1235111014 | Loretto Glynn | Surgery | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194081760 | Britney Lynne Grayson | Surgery | 8040 Clearvista Pkwy Ste 460, Indianapolis, IN 46256-4673 | 2012-04-07 |
| 1962592469 | Evan R. Kokoska | Surgery | 2001 W. 86th Street, Pediatric Hospital, Indianapolis, IN 46260 | 2006-10-13 |
| 1790880292 | Pediatric Surgical Associates Inc | Surgery | 250 N Shadeland Ave Ste 200, Indianapolis, IN 46219-4959 | 2006-09-13 |
| 1902833395 | Sunghoon Kim | Surgery | 8040 Clearvista Pkwy Ste 340, Indianapolis, IN 46256-4673 | 2006-06-28 |
| 1225464324 | Halkawt Ali Nuri | Surgery | 545 Barnhill Dr, Suite 215, Indianapolis, IN 46202-5112 | 2013-09-20 |
| 1184881641 | Jeremy Herrmann | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2008-05-21 |
| 1548317431 | Matthew Landman | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2007-01-04 |
| 1811066608 | Robert C Burns | Surgery | 705 Riley Hospital Dr, Ste 2500, Indianapolis, IN 46202-5109 | 2006-11-07 |
| 1699855304 | John W Brown | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-10-17 |
| 1841393311 | Mark Rodefeld | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-09-07 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on PAUL T. STOCKMANN.
| 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.