PROFESSIONAL EMERGENCY PHYSICIANS INC (NPI# 1992812861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992812861 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL EMERGENCY PHYSICIANS INC |
| Practice Address |
11115 Parkview Plaza Dr Fort Wayne IN 46845-1701 |
| Mailing Address |
2414 E State Blvd Suite 202 Fort Wayne IN 46805-4760 |
| Practice Telephone | 2606724000 |
| Mailing Telephone | 2604824440 |
| Mailing Fax Number | 2604824442 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS E GUTWEIN (PRESIDENT) |
| Authorized Official Telephone | 2604824440 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2517762 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528175411 | Professional Emergency Physicians Inc | Emergency Medicine | 2001 Stults Rd, Huntington, IN 46750-1291 | 2006-08-24 |
| 1184731069 | Professional Emergency Physicians Inc | Emergency Medicine | 353 N Oak St, Columbia City, IN 46725-1623 | 2006-08-24 |
| 1215044102 | Professional Emergency Physicians Inc | Emergency Medicine | 401 N Sawyer Rd, Kendallville, IN 46755-2568 | 2006-08-24 |
| Street Address |
11115 PARKVIEW PLAZA DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932106317 | Jayesh P Patel | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2005-06-30 |
| 1003473307 | Angela Booth | Registered Nurse | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2019-05-22 |
| 1942696356 | Sarah E Brandenberger | Genetic Counselor, MS | 11115 Parkview Plaza Dr, Attn: Sarah King, Fort Wayne, IN 46845-1701 | 2015-04-13 |
| 1588058739 | Halie Hoang Kudumula | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2015-03-26 |
| 1639425291 | Lisa Marie Piwoszkin | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2012-07-31 |
| 1235424482 | Christen A Merkler | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2011-06-16 |
| 1730400714 | Rachel Miller | Registered Nurse | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2010-06-14 |
| 1225250129 | Ravi Kudumula | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2007-05-02 |
| 1104950799 | Win Boon | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2007-03-15 |
| 1700984002 | Emily J Deneve | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2006-09-20 |
| Find all providers in the same location | ||||
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154777613 | Michael J Bojrab | Emergency Medicine | 6720 Kirkdale Dr, Fort Wayne, IN 46815-5524 | 2016-05-13 |
| 1073939450 | Whitney Miller | Emergency Medicine | 10343 Dawsons Creek Blvd Ste A, Fort Wayne, IN 46825 | 2014-03-10 |
| 1538401732 | Nicholas Salvatore Costanza | Emergency Medicine | 4225 Frost Grass Dr, Henry Ford Macomb Hospitals, Fort Wayne, IN 46845-8010 | 2013-03-26 |
| 1235459603 | Sheila K Pittenger | Emergency Medicine | 3684 New Vision Drive, Fort Wayne, IN 46845 | 2010-06-08 |
| 1881808012 | Roderick G Morrison | Emergency Medicine | 11109 Parkview Plaza Drive, Fort Wayne, IN 46845-1701 | 2007-05-09 |
| 1902982796 | Walter Osborne Jackson | Emergency Medicine | 10329 Greenoak Blvd, Fort Wayne, IN 46814-9546 | 2006-10-27 |
| 1255416947 | Kamlesh Patel | Emergency Medicine | 1638 Carroll Rd, Fort Wayne, IN 46845-9373 | 2006-10-25 |
| 1245259944 | Stephen Mcconnell | Emergency Medicine | 2825 Barry Knoll Way, Fort Wayne, IN 46845-1944 | 2006-07-19 |
| 1326067000 | Dennis Dale Mansfield | Emergency Medicine | 7950 W Jefferson Blvd Ste 2121, Fort Wayne, IN 46804-4140 | 2006-07-19 |
| 1588683122 | Aiman Hassan | Emergency Medicine | 6036 Trier Rd, Fort Wayne, IN 46815-5337 | 2006-07-18 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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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.