Fort Wayne Orthopaedics, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

50002482 Issued in IN

Legal business name

FORT WAYNE ORTHOPAEDICS, LLC

Practice address

306 E Maumee St, Ste. 304
Angola, IN 46703-2035

Phone

(260) 436-8686

Fax

(260) 436-8585

NPI assigned

Aug 13, 2010

Organization subpart

No

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

Authorized official

Name

Jerald L. Cooper, MD

Title

Physician/Owner

Phone

(260) 436-8686

Specialties & licenses 9

Addresses

Other identifiers 5

Other names 1

• Fort Wayne Orthopedics, LLC Doing business as

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Fort Wayne Orthopaedics LLC

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
  • NPI 1497758429

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1104131259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468012526",
            "telephone_number": "866-413-9534",
            "fax_number": "260-407-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST, STE. 304",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032035",
            "telephone_number": "260-436-8686",
            "fax_number": "260-436-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE ORTHOPAEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "260-436-8686",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "50002482",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "50002482",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME REGION B",
            "identifier": "0162610004",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100210470A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "0162610004",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100210470",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300049590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Wayne Orthopedics, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Wayne Orthopedics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Katherine Fisher, LMFT
• Gregory L Folck, RPH
• Laura M Folds, N.P.
• Morgan Forker
• Fort Wayne Medical Oncology and Hematology, Inc.
• Benjamin Forte
• Simone Frappier, OBHP BS
• Susan Frayer, MD
• Chelsea Friend, MA
• Jenniffer J Friskney

• All providers in Angola, IN
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.