Keith R Davis (NPI# 1235129859, PAC ID# 5395733273) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1235129859 |
| PAC ID by PECOS | 5395733273 |
| Professional Enrollment ID | I20040503000314 |
| Full Name | Keith R Davis |
| Organization Legal Name | ASSOCIATED SURGEONS AND PHYSICIANS LLC |
| Address |
7988 W Jefferson Blvd Fort Wayne IN 46804-4140 |
| Phone Number | 2604324400 |
| Gender | M |
| Credential | MD |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 2668539818 |
| Number of Group Practice Members | 42 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150017 | LUTHERAN HOSPITAL OF INDIANA |
| 150150 | DUPONT HOSPITAL LLC |
| Address | Phone | Organization |
|---|---|---|
| 11141 Parkview Plaza Dr, Suite 325, Fort Wayne, IN 46845-1714 | 2604324400 | ASSOCIATED SURGEONS AND PHYSICIANS LLC |
| 2518 E Dupont Rd, Womens Health Advantage, Fort Wayne, IN 46825-1675 | 2604324400 | ASSOCIATED SURGEONS AND PHYSICIANS LLC |
| 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2604324400 | ASSOCIATED SURGEONS AND PHYSICIANS LLC |
| Organization Legal Name | ASSOCIATED SURGEONS AND PHYSICIANS LLC |
| Physicians | 45 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Dirig | Nurse Practitioner | Associated Surgeons and Physicians LLC | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 |
| Larson Langschwager | Obstetrics/gynecology | Associated Surgeons and Physicians LLC | 1316 E 7th St, Auburn, IN 46706-2538 |
| Mary J Gura | Nurse Practitioner | Associated Surgeons and Physicians LLC | 2518 E Dupont Rd, Womens Health Advantage, Fort Wayne, IN 46825-1675 |
| Sarah B Bailey | Nurse Practitioner | Associated Surgeons and Physicians LLC | 1275 Provident Dr, Warsaw, IN 46580-3265 |
| Mark W Delbello | Internal Medicine | Associated Surgeons and Physicians LLC | 10002 Auburn Park Dr, Fort Wayne, IN 46825-2389 |
| Tara J Little | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Debra K Brandenberger | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Andrea F Yoder | Certified Nurse Midwife (cnm) | Associated Surgeons and Physicians LLC | 2518 E Dupont Rd, Womens Health Advantage, Fort Wayne, IN 46825-1675 |
| Rachael L Johnson | Nurse Practitioner | Associated Surgeons and Physicians LLC | 1275 Provident Dr, Warsaw, IN 46580-3265 |
| Abbie Lois Mincks | Obstetrics/gynecology | Associated Surgeons and Physicians LLC | 2518 E Dupont Rd, Womens Health Advantage, Fort Wayne, IN 46825-1675 |
| Street Address |
7988 W JEFFERSON BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip | 46804-4140 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Dirig | Nurse Practitioner | Associated Surgeons and Physicians LLC | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 |
| Lucia A Fouts Grubbs | Obstetrics/gynecology | Associated Surgeons and Physicians LLC | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 |
| Ravi D Raju | Obstetrics/gynecology | Associated Surgeons and Physicians LLC | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 |
| Nina P Levenda | Obstetrics/gynecology | Associated Surgeons and Physicians LLC | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly A Griffith | Speech Language Pathologist | 6205 Constitution Dr, Fort Wayne, IN 46804-1517 | |
| Michael Scherbinski | Clinical Psychologist | Prometheus Psychological Services | 6229 Constitution Dr, Fort Wayne, IN 46804-1517 |
| Jessie Whiteman | Nurse Practitioner | Rp Care LLC | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Monique L M Levesque-hartle | Chiropractic | Allen County Chiropractic LLC | 6320 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Amy Harmeyer | Nurse Practitioner | Rp Care LLC | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Casey Peterson | Nurse Practitioner | Rp Care LLC | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Ashley Brown | Nurse Practitioner | Rp Care LLC | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Nicholas Hammond | Physician Assistant | Rp Care LLC | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Barbara L Starry | Nurse Practitioner | Rp Care LLC | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Rochelle L Johnson | Nurse Practitioner | Rounding Providers | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 |
| Find all physicians in zip 46804 | |||
| City | FORT WAYNE |
| Zip Code | 46804 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | FORT WAYNE + OBSTETRICS/GYNECOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.