Foundation Surgery Affiliate of Fort Wayne, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PENDING Issued in IN

Legal business name

FOUNDATION SURGERY AFFILIATE OF FORT WAYNE, LLC

Practice address

8004 Carnegie Blvd.
Fort Wayne, IN 46804-5785

Phone

(260) 434-3600

Fax

(260) 434-3680

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jessica Lee-Hansen, N/A

Title

Cfo

Phone

(312) 388-0125

Specialties & licenses 1

Addresses

Other names 1

• Parkview Southwest Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

Parview Inverness Surgery CenterCCN 15C0001147

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Parkview Health System, Inc.

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1952411233

  Member Of

  NPD member
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603

  Member Of

  NPD member

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1144275629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8004 CARNEGIE BLVD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045785",
            "telephone_number": "260-434-3600",
            "fax_number": "260-434-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8004 CARNEGIE BLVD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045785",
            "telephone_number": "260-434-3600",
            "fax_number": "260-434-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION SURGERY AFFILIATE OF FORT WAYNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "LEE-HANSEN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-388-0125",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkview Southwest Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nideo Foster, DPT, PT
• Richard Foster
• Susanne Foster
• Whitney R Foster, NP-C
• Kimberly K Foulks, RN
• Fountain of Hope Home Care Services LLC
• Pamela Kinder Fountain, MSN, RNC, APRN-BC
• Lindsey Foust, MS, LAT, ATC
• Lucia A. Fouts Grubbs, MD
• John B Fouts, MD

• Ambulatory Surgical Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.