Fort Wayne Brain & Spine Center LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

FORT WAYNE BRAIN & SPINE CENTER LLC

Practice address

7910 W Jefferson Blvd Ste 205B
Fort Wayne, IN 46804-0072

Phone

(111) 111-1111

NPI assigned

Jul 16, 2026

Last updated

Aug 12, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shahnawaz Qureshi, DONPI 1861603466

Title

Owner

Phone

(111) 111-1111

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shahnawaz H Qureshi, DO

  • Neurological Surgery Physician
  • Fort Wayne, IN
  • NPI 1861603466
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1784160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1043130651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 205B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468040072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 205B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468040072",
            "telephone_number": "111-111-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE BRAIN & SPINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-16",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "SHAHNAWAZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "111-111-1111",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Neurological Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.